health centre management (hcm 02) drug supply · centre management – drug supply management. 2 3...
TRANSCRIPT
Trainer Manual - H
CM 02
Drug Supply Management
Health Centre Management (HCM 02)
The ACT PRIME Study
Infectious Disease Research Collaboration, Uganda.ACT Consortium, London School of Hygiene & Tropical Medicine, UK.
1Trainer Manual - HCM 02
Tabl
e of
Con
tent
s
TRA
INER
BRI
EF –
HCM
02
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2
TRA
ININ
G A
GEN
DA
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....3
INTR
OD
UCT
ION
TO
TH
E M
OD
ULE
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5
1. G
reet
ings
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7
2. T
rain
ing
ratio
nale
and
lear
ning
out
com
es ..
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...10
TOPI
C 1:
DRU
G D
ISTR
IBU
TIO
N S
YSTE
M &
FO
RMS
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....1
1
1. In
trodu
ctio
n to
the
topi
c ...
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...12
2. T
hink
ing
abou
t the
topi
c ....
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..13
3. P
rinci
ples
– T
he d
rug
dist
ribut
ion
syst
em ...
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.....1
6
4. P
rinci
ples
– T
he O
PD R
egis
ter ..
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.17
5. P
rinci
ples
– T
he S
tock
Car
d ....
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...17
6. P
ract
ice
– Th
e St
ock
Card
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....1
8
7. P
rinci
ples
– T
he O
rder
For
m ..
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...23
8. P
ract
ice
– Th
e O
rder
For
m ..
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9. D
iscu
ssio
n ...
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.26
10. P
lann
ing
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.27
TOPI
C 2:
KEE
PIN
G T
RACK
OF
DRU
G D
ISTR
IBU
TIO
N A
CTIV
ITIE
S ...
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.....3
1
1. In
trodu
ctio
n to
the
topi
c ...
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...32
2. T
hink
ing
abou
t the
topi
c ....
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..33
3. P
rinci
ples
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.38
4. P
ract
ice
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...39
5. D
iscu
ssio
n ...
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6. P
lann
ing
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.41
CON
CLU
SIO
N ..
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3
AN
NEX
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45
Infe
ctio
us D
isea
ses
Rese
arch
Col
labo
ratio
n &
ACT
Con
sort
ium
, Lon
don
Scho
ol o
f H
ygie
ne &
Tro
pica
l Med
icin
e (2
011).
The
ACT
PRI
ME
Stud
y Tr
aine
r Man
ual:
Hea
lth
Cent
re M
anag
emen
t – D
rug
Supp
ly M
anag
emen
t.
23
Trainer Manual - HCM 02
Trainer Manual - HCM 02
Self-
obse
rvat
ion
Activ
ities
- W
elco
me
Trai
ner B
rief
Trai
ner B
rief –
HCM
02
From
Oct
ober
200
9 un
til F
ebru
ary
2010
, the
Uga
nda
Mal
aria
Sur
veill
ance
Pro
ject
/
Infe
ctio
us D
isea
se R
esea
rch
Colla
bora
tion
cond
ucte
d re
sear
ch a
ctiv
ities
in To
roro
D
istri
ct.
We
surv
eyed
hou
seho
lds,
hea
lth w
orke
rs a
nd c
omm
unity
med
icin
e di
strib
utor
s, a
nd ta
lked
to g
roup
s of
com
mun
ity m
embe
rs a
nd h
ealth
wor
kers
to le
arn
mor
e ab
out h
ow h
ealth
car
e is
pro
vide
d to
sic
k ch
ildre
n in
this
are
a, e
spec
ially
at
heal
th c
entre
s.
We
foun
d th
at w
hen
child
ren
are
sick
, car
egiv
ers
usua
lly s
eek
treat
men
t fro
m th
e he
alth
cen
tre, b
ut th
ey a
lso
use
com
mun
ity m
edic
ine
dist
ribut
ors,
priv
ate
clin
ics,
dru
g sh
ops,
trad
ition
al h
erba
lists
, or c
hurc
hes.
Diff
eren
t fac
tors
influ
ence
whe
re p
eopl
e se
ek c
are
incl
udin
g tim
e, c
ost,
avai
labi
lity
of d
rugs
, and
wha
t tre
atm
ent h
as w
orke
d w
ell i
n th
e pa
st.
We
foun
d th
at c
areg
iver
s ar
e no
t alw
ays
satis
fied
with
the
treat
men
t at
the
heal
th c
entre
whe
n th
ey h
ave
to p
ay o
r whe
n dr
ugs
are
not a
vaila
ble.
Rec
eivi
ng
a di
agno
sis
but n
ot re
ceiv
ing
prop
er tr
eatm
ent w
as v
iew
ed a
s in
com
plet
e an
d po
or
qual
ity c
are
by c
omm
unity
mem
bers
.
We
also
foun
d th
at th
e si
tuat
ion
at h
ealth
cen
tres
need
s to
be
impr
oved
. A
lmos
t all
heal
th c
entre
s us
ually
hav
e st
ock-
outs
of k
ey m
edic
ines
to tr
eat m
alar
ia a
nd o
ther
ill
ness
es.
Hea
lth w
orke
rs re
porte
d th
at th
ey a
re fr
ustra
ted
with
the
lack
of d
rugs
an
d eq
uipm
ent a
nd b
elie
ve th
at p
atie
nts
are
diss
atis
fied
with
thei
r car
e w
hen
they
le
ave
the
heal
th fa
cilit
y w
ithou
t dru
gs.
Hea
lth w
orke
rs a
lso
repo
rted
that
they
lack
kn
owle
dge
abou
t the
dru
g de
liver
y sy
stem
and
are
con
fuse
d ab
out t
he ro
les
and
resp
onsi
bilit
ies
of s
taff
invo
lved
in d
rug
proc
urem
ent.
The
key
lear
ning
out
com
es fo
r HCM
02
are
as fo
llow
s:
Topi
cLe
arni
ng O
utco
mes
By th
e en
d of
this
mod
ule
part
icip
ants
will
: Pr
inci
ples
of t
he d
rug
dist
ribut
ion
syst
em D
escr
ibe
the
mai
n co
mpo
nent
s of
the
drug
dis
tribu
tion
syst
em.
Be
mot
ivat
ed to
act
ivel
y pa
rtici
pate
in a
nd k
eep
the
drug
di
strib
utio
n sy
stem
on
track
.Fo
rms
requ
ired
in d
rug
dist
ribut
ion
cycl
e D
escr
ibe
the
purp
ose
and
bene
fit o
f com
plet
ing
form
s re
quire
d in
the
drug
dis
tribu
tion
syst
em in
clud
ing:
- O
PD re
gist
er
-
Stoc
k-ca
rd (F
orm
015
)
- O
rder
For
m (F
orm
085
) A
ccur
atel
y co
mpl
ete
the
form
s re
quire
d in
the
drug
di
strib
utio
n sy
stem
. P
ut in
pla
ce a
pla
n fo
r com
plet
ing
the
form
s re
gula
rly a
t the
he
ath
cent
re.
Keep
ing
trac
k of
dru
g di
strib
utio
n ac
tiviti
es Id
entif
y th
e ac
tiviti
es re
quire
d to
get
dru
gs fr
om th
e D
istri
ct
or H
ealth
Sub
-Dis
trict
to th
e he
alth
cen
tre.
Iden
tify
chal
leng
es a
nd s
olut
ions
to c
ompl
etin
g dr
ug
dist
ribut
ion
syst
em a
ctiv
ities
. B
e m
otiv
ated
to k
eep
track
of h
ealth
cen
tre le
vel a
ctiv
ities
in
the
drug
dis
tribu
tion
syst
em.
HCM
02
will
last
3½
hou
rs fr
om s
tart
to fi
nish
.
Topi
csTi
me
allo
cate
dSt
art
time
End
time
Tota
l Tim
eM
ater
ials
Intro
duct
ion
to th
e m
odul
e- G
reet
ings
- Tra
inin
g ra
tiona
le a
nd
Lear
ning
out
com
es5
min
utes
10
min
utes
____
____
____
____
____
____
15 m
inut
esFl
ip c
hart
Mar
kers
Tape
TOPI
C 1:
Dru
g D
istr
ibut
ion
Syst
em &
For
ms
- Int
rodu
ctio
n to
the
topi
c- T
hink
ing
abou
t the
topi
c- P
rinci
ples
- D
rug
Dis
tribu
tion
- Prin
cipl
es -
The
OPD
Reg
iste
r- P
rinci
ples
- Th
e St
ock
Card
- Pra
ctic
e - S
tock
Car
d- P
rinci
ples
- Th
e O
rder
For
m- P
ract
ice
- The
Ord
er F
orm
- Dis
cuss
ion
- Pla
nnin
g
5 m
inut
es10
min
utes
15 m
inut
es5
min
utes
5 m
inut
es30
min
utes
5 m
inut
es10
min
utes
10 m
inut
es10
min
utes
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
85 m
inut
es
Ann
ex
A,B
,C,D
,E,
F (1-
4), G
, HFl
ip c
hart
Mar
kers
Tape
Brea
k30
min
utes
TOPI
C 2:
Kee
ping
Tra
ck o
f D
rug
Dis
trib
utio
n A
ctiv
ities
- I
ntro
duct
ion
to th
e to
pic
- Thi
nkin
g ab
out t
he to
pic
- Prin
cipl
es- P
ract
ice
- Dis
cuss
ion
- Pla
nnin
g
15 m
inut
es15
min
utes
10 m
inut
es15
min
utes
10 m
inut
es10
min
utes
__
____
____
____
____
____
____
____
____
__
__
____
____
____
____
____
____
____
____
__
75 m
inut
es
Flip
Cha
rtM
arke
rsTa
peA
nnex
I,
J, K
Conc
lusi
on5
min
utes
____
____
____
5 m
inut
esFl
ip c
hart
Mar
kers
TOTA
L20
5 m
inut
es =
3 h
ours
& 2
5 m
inut
es
TRA
ININ
G A
GEN
DA
– H
CM 0
2
Not
e to
Tra
iner
:Tr
aine
rs, p
leas
e us
e th
e ta
ble
belo
w to
com
plet
e th
e st
art a
nd e
nd ti
mes
for
each
trai
ning
sec
tion
usin
g th
e ‘Ti
me
Allo
cate
d’ a
s a
guid
e.
Ke
ep th
is a
gend
a vi
sibl
e an
d as
a g
uide
to h
elp
you
keep
trac
k of
tim
e.
Toda
y’s
trai
ning
will
sta
rt a
t ___
_:__
__
Tod
ay’s
trai
ning
will
end
by
____
:___
_
Trai
ning
Age
nda
45
Trainer Manual - HCM 02Trainer Manual - HCM 02
Self-
obse
rvat
ion
Activ
ities
- W
elco
me
Intro
duct
ion
to th
e M
odul
e
INTR
OD
UCT
ION
TO
TH
E M
OD
ULE
Tota
l Tim
e: 1
5 m
inut
es
Purp
ose:
To w
elco
me
and
orie
nt th
e pa
rtici
pant
s to
the
train
ing
and
help
th
em to
und
erst
and
wha
t the
y ca
n ex
pect
of t
he tr
aini
ng a
nd w
hat w
ill b
e ex
pect
ed o
f the
m a
s pa
rtici
pant
s.
Lear
ning
Out
com
es: B
y th
e en
d of
this
ses
sion
par
ticip
ants
will
:
1) Kn
ow th
e na
mes
of c
o-pa
rtici
pant
s.2)
Kno
w th
e na
me
of th
e tra
inin
g le
ader
.3)
Rev
iew
a s
et o
f gro
und
rule
s fo
r the
trai
ning
.4)
Rev
iew
the
prev
ious
mod
ule’
s ke
y le
arni
ng p
oint
s.5)
Kno
w th
e le
arni
ng o
utco
mes
and
pur
pose
of t
he m
odul
e.
Mat
eria
ls re
quire
d:
Flip
cha
rt M
arke
rs
Tape
Gro
und
rule
s pr
e-pr
epar
ed fl
ip c
hart
Trai
ning
met
hods
use
d:
Gro
up D
iscu
ssio
n R
evie
w C
ircle
s
Page
7
Addi
tiona
l Not
es
67
Trainer Manual - HCM 02Trainer Manual - HCM 02
Intro
duct
ion
to th
e M
odul
eIn
trodu
ctio
n to
the
Mod
ule
Step
2: E
XPLA
IN:
My
nam
e is
___
____
____
____
___
and
I wor
k w
ith th
e U
gand
a M
alar
ia S
urve
illanc
e Pr
ojec
t/In
fect
ious
Dis
ease
s Re
sear
ch C
olla
bora
tion
(IDRC
).
I am
goi
ng to
be
lead
ing
you
toda
y.
1. G
reet
ings
& R
evie
w
5 m
inut
es
Trai
ning
Ste
ps
Step
1: G
REET
:
With
a fr
iend
ly s
mile
, wel
com
e al
l par
ticip
ants
as
they
arr
ive.
Giv
e ea
ch p
erso
n a
nam
e ta
g, le
arne
r man
ual a
nd a
ny s
uppl
ies
and
ask
them
to ta
ke a
sea
t any
whe
re
they
like
.
Not
e to
Tra
iner
:O
nce
all o
f the
par
ticip
ants
hav
e ar
rived
, or i
t is
the
sche
dule
d tim
e to
sta
rt th
e tra
inin
g, b
egin
with
intro
duct
ions
as
desc
ribed
bel
ow.
Step
3: A
SK:
You
will
rem
embe
r the
gro
und
rule
s w
e ag
reed
upo
n la
st ti
me
– th
ese
are
note
d on
th
e fli
p ch
art a
s a
rem
inde
r.
Prep
arat
ion
To b
e co
mpl
eted
bef
ore
part
icip
ants
arr
ive:
1) H
ang
up a
flip
cha
rt an
d ar
rang
e yo
ur m
anua
l and
sup
plie
s.
2) W
rite
on th
e fli
p ch
art:
the
nam
e of
the
mod
ule,
you
r nam
e &
the
orga
nisa
tion
you
wor
k w
ith.
3) E
nsur
e th
e ro
om is
sw
ept &
cle
an.
4) E
nsur
e al
l the
cha
irs a
re in
a fr
iend
ly w
ell s
pace
d an
d th
ere
are
enou
gh c
hairs
fo
r all
the
parti
cipa
nts
you
are
expe
ctin
g.
5) S
et th
e tim
e yo
u w
ill s
tart
the
train
ing
and
com
plet
e th
e ‘s
tart’
and
‘end
’ tim
es o
n th
e Tr
aini
ng A
gend
a fo
r eac
h tra
inin
g se
ctio
n. W
rite
the
star
t and
end
tim
es o
n th
e fli
p ch
art.
6) H
ang
up th
e ‘G
roun
d Ru
les’
flip
cha
rt fro
m P
CS 0
0. I
f you
do
not h
ave
the
flip
char
t or t
he g
roun
d ru
les,
you
may
ask
one
of t
he p
artic
ipan
ts to
hel
p yo
u cr
eate
th
e fli
p ch
art w
hen
he/s
he a
rriv
es –
the
parti
cipa
nts
shou
ld h
ave
the
rule
s w
ritte
n in
thei
r Lea
rner
Man
ual.
Room
Set
up
Be
on t
ime
Turn
off
you
r
mob
ile p
hon
es
Use
con
stru
ctiv
e
feed
back
89
Trainer Manual - HCM 02Trainer Manual - HCM 02
Intro
duct
ion
to th
e M
odul
eIn
trodu
ctio
n to
the
Mod
ule
Step
4: A
SK:
We
are
goin
g to
sta
rt w
ith a
n ac
tivity
to re
call
wha
t we
cove
red
toge
ther
in th
e pr
evio
us tr
aini
ng. P
leas
e tu
rn to
pag
e 8
of y
our m
anua
ls w
here
ther
e ar
e re
view
ci
rcle
s.
We
will
mov
e ar
ound
the
circ
le. S
tarti
ng w
ith th
e fir
st c
ircle
, eac
h pe
rson
will
read
ou
t one
of t
he s
tate
men
ts in
side
the
revi
ew c
ircle
s. Y
ou c
an c
hoos
e an
y ki
nd o
f vo
ice
– a
deep
voi
ce, a
sin
ging
voi
ce –
just
be
sure
that
you
spe
ak c
lear
ly s
o al
l can
he
ar y
ou! P
leas
e st
art b
y gr
eetin
g th
e pe
rson
bes
ide
you
and
sayi
ng th
eir n
ame
of
the
pers
on b
esid
e yo
u, b
efor
e re
adin
g th
e st
atem
ent –
this
will
rem
ind
us o
f eac
h ot
hers
’ nam
es.
Your
Not
es
A go
od p
lace
to w
rite
the
nam
es o
f par
ticip
ants
or q
uest
ions
that
aris
e.
Not
e to
Tra
iner
:St
art t
he p
roce
ss b
y tu
rnin
g to
the
pers
on b
esid
e yo
u an
d sa
ying
her
nam
e.
Th
e pr
oces
s co
ntin
ues
until
all
the
revi
ew c
ircle
s ha
ve b
een
read
.
Revi
ew C
ircle
s A
ccou
ntab
ility
mea
ns
actin
g w
ith re
spon
sibi
lity
and
trans
pare
ncy
in e
very
thin
g w
e do
in
clud
ing
wha
t we
say
and
how
we
com
plet
e ou
r dai
ly ta
sks.
Whe
n th
e qu
aliti
es
of a
goo
d in
cha
rge
are
com
bine
d in
to
one
heal
th w
orke
r, w
e cr
eate
the
pict
ure
of
an in
-cha
rge
who
is
‘acc
ount
able
’ or s
how
s ac
coun
tabi
lity.
The
PHC
Fund
can
be
use
d fo
r: ou
treac
h,
paym
ent o
f sup
port
staf
f, m
aint
enan
ce
of fa
cilit
y, p
urch
ase
of s
undr
ies,
infe
ctio
n pr
even
tion
mat
eria
ls,
and
volu
ntee
rs.
Budg
etin
g in
clud
es
Plan
ning
, Prio
ritis
atio
n an
d D
evel
opm
ent.
Show
ing
acco
unta
bilit
y by
usi
ng a
rece
ipt
for e
ach
expe
nse
is
esse
ntia
l.
Acc
ount
ing
allo
ws
on
e to
see
if o
ne is
m
eetin
g th
e pl
ans
mad
e in
the
budg
et.
It in
clud
es:
Impl
emen
tatio
n;
Mon
itorin
g an
d Co
mm
unic
atio
n.
Acc
ount
ing
is a
way
to
keep
trac
k of
wha
t you
ar
e sp
endi
ng a
nd to
ad
just
you
r spe
ndin
g fo
r fu
ture
mon
ths.
In-c
harg
es m
ust
budg
et in
ord
er to
co
mm
it th
emse
lves
to
man
agin
g th
e m
oney
in
stea
d of
letti
ng
the
mon
ey
man
age
them
.
Mor
e do
cum
enta
tion
of h
ow th
e PH
C Fu
nd
is b
udge
ted
and
acco
unte
d fo
r at
the
heal
th c
entre
is
requ
ired
to s
how
ac
coun
tabi
lity.
The
PHC
Fund
is a
m
anag
eabl
e am
ount
of
mon
ey th
at is
use
d ev
ery
day
at o
ur h
ealth
ce
ntre
s, s
o it
is im
porta
nt
that
we
man
age
it
wel
l.
Step
5: E
XPLA
IN:
Plea
se c
ontin
ue to
use
you
r Lea
rner
Man
uals
in th
e w
ay th
at s
uits
you
bes
t. I w
ill le
t yo
u kn
ow w
hen
to re
fer t
o yo
ur m
anua
l, bu
t ple
ase
also
feel
free
to ta
ke y
our o
wn
note
s.
1011Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
s
Trainer Manual - HCM 02
Intro
duct
ion
to th
e M
odul
e
Step
2: E
XPLA
IN:
The
lear
ning
out
com
es fo
r the
mod
ule
can
be fo
und
in y
our L
earn
er M
anua
ls o
n pa
ge 9
and
are
as
follo
ws:
3. T
rain
ing
ratio
nale
and
lear
ning
out
com
es
10
min
utes
Trai
ning
Ste
ps
Step
1: I
NTR
OD
UCE
TH
E M
OD
ULE
:
Not
e to
Tra
iner
:U
se p
oint
s fro
m th
e Tr
aine
r Brie
f on
page
2 to
intro
duce
the
mod
ule
and
expl
ain
the
ratio
nale
and
pur
pose
of t
his
mod
ule.
Sim
ilar i
nfor
mat
ion
from
the
Trai
ner B
rief i
s al
so in
clud
ed in
the
Lear
ner M
anua
l on
page
4 fo
r pa
rtici
pant
s to
revi
ew.
Not
e to
Tra
iner
: R
ecei
ve re
spon
ses.
Step
3: A
SK:
Doe
s an
yone
hav
e an
y qu
estio
ns?
TOPI
C 1:
DRU
G D
ISTR
IBU
TIO
N S
YSTE
M
& F
ORM
S
Tota
l Tim
e: 8
5 m
inut
es
Purp
ose:
To in
trodu
ce p
artic
ipan
ts to
the
drug
dis
tribu
tion
syst
em, t
he fo
rms
used
in
the
syst
em, a
nd th
e ro
le in
-cha
rges
can
pla
y to
kee
p th
e sy
stem
on
track
.
Lear
ning
Out
com
es: B
y th
e en
d of
this
ses
sion
par
ticip
ants
will
:
1) D
escr
ibe
the
mai
n co
mpo
nent
s of
the
drug
dis
tribu
tion
syst
em.
2) B
e m
otiv
ated
to a
ctiv
ely
parti
cipa
te in
and
kee
p th
e dr
ug d
istri
butio
n sy
stem
on
trac
k.
3) D
escr
ibe
the
purp
ose
and
bene
fit o
f com
plet
ing
form
s re
quire
d in
the
drug
di
strib
utio
n sy
stem
incl
udin
g:
- O
PD re
gist
er
- St
ock-
card
(For
m 0
15)
- O
rder
For
m (F
orm
085
)
4) A
ccur
atel
y co
mpl
ete
the
form
s re
quire
d in
the
drug
dis
tribu
tion
syst
em.
5) P
ut in
pla
ce a
pla
n fo
r com
plet
ing
the
form
s re
gula
rly a
t the
hea
th c
entre
.
Mat
eria
ls re
quire
d:
Flip
cha
rt M
arke
rs
Tape
Ann
ex A
, B,C
,D,E
,F (1
-4),G
,H
Trai
ning
met
hods
use
d:
Dis
cuss
ion
Lec
ture
Pra
ctic
e
Page
11
Topi
cLe
arni
ng O
utco
mes
By th
e en
d of
this
mod
ule
part
icip
ants
will
: Pr
inci
ples
of t
he d
rug
dist
ribut
ion
syst
em D
escr
ibe
the
mai
n co
mpo
nent
s of
the
drug
dis
tribu
tion
syst
em.
Be
mot
ivat
ed to
act
ivel
y pa
rtici
pate
in a
nd k
eep
the
drug
di
strib
utio
n sy
stem
on
track
.Fo
rms
requ
ired
in d
rug
dist
ribut
ion
cycl
e D
escr
ibe
the
purp
ose
and
bene
fit o
f com
plet
ing
form
s re
quire
d in
the
drug
dis
tribu
tion
syst
em in
clud
ing:
- O
PD re
gist
er
-
Stoc
k-ca
rd (F
orm
015
)
- O
rder
For
m (F
orm
085
) A
ccur
atel
y co
mpl
ete
the
form
s re
quire
d in
the
drug
di
strib
utio
n sy
stem
. P
ut in
pla
ce a
pla
n fo
r com
plet
ing
the
form
s re
gula
rly a
t the
he
ath
cent
re.
Keep
ing
trac
k of
dru
g di
strib
utio
n ac
tiviti
es Id
entif
y th
e ac
tiviti
es re
quire
d to
get
dru
gs fr
om th
e D
istri
ct
or H
ealth
Sub
-Dis
trict
to th
e he
alth
cen
tre.
Iden
tify
chal
leng
es a
nd s
olut
ions
to c
ompl
etin
g dr
ug
dist
ribut
ion
syst
em a
ctiv
ities
. B
e m
otiv
ated
to k
eep
track
of h
ealth
cen
tre le
vel a
ctiv
ities
in
the
drug
dis
tribu
tion
syst
em.
1213Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
s
Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
s
1. In
trodu
ctio
n to
the
topi
c
5 m
inut
es
Trai
ning
Ste
ps
Step
1:
ACT
IVIT
Y A
– T
rain
son
g
Act
ivity
Ste
ps
DIV
IDE
part
icip
ants
into
four
gro
ups
and
allo
cate
eac
h gr
oup
to a
cho
rus
from
th
e tra
in s
ong,
or a
ny o
ther
son
g yo
u kn
ow th
at is
sun
g in
roun
ds.
Refe
r the
m
to p
age
11.
St
art w
ith G
roup
1, th
en a
dd in
oth
er G
roup
s in
a ro
und.
Par
ts fo
r eac
h gr
oup
are:
Gro
up 1
star
ts w
ith:
to-to
-to-to
….
Gro
up 2
join
s in
with
: to
who
m to
, to
who
m to
...G
roup
3 jo
ins
in w
ith: t
o w
hom
doe
s it
belo
ng…
G
roup
4 jo
ins
in w
ith: t
o yo
u! to
you
!...
SIN
G th
e Tr
ain
Song
cho
rus
seve
ral t
imes
and
enc
oura
ge p
artic
ipan
ts to
dan
ce
alon
g.
Step
2: E
XPLA
IN:
Get
ting
drug
s to
you
r hea
lth c
entre
is li
ke m
ovin
g a
train
alo
ng a
trac
k. T
here
are
di
ffere
nt p
arts
that
hav
e to
wor
k to
geth
er to
kee
p th
e tra
in –
the
drug
s –
on tr
ack
and
mov
ing
to y
our h
ealth
cen
tre.
Each
per
son
and
each
leve
l of t
he h
ealth
sys
tem
ha
s a
role
and
resp
onsi
bilit
y to
ens
ure
all s
teps
of t
he d
rug
dist
ribut
ion
syst
em a
re
com
plet
ed a
s pl
anne
d.
Toda
y w
e ar
e go
ing
to fo
cus
on y
our r
ole
in th
e dr
ug d
istri
butio
n sy
stem
and
wha
t yo
u ca
n do
to h
elp
get d
rugs
to y
our h
ealth
cen
tre.
2. T
hink
ing
abou
t the
topi
c
10
min
utes
Trai
ning
Ste
ps
Step
1: E
XPLA
IN:
Let’s
thin
k ab
out t
he d
rug
dist
ribut
ion
syst
em in
Uga
nda.
I a
m g
oing
to h
and
out
piec
es o
f pap
er w
ith d
iffer
ent s
teps
of t
he d
rug
dist
ribut
ion
syst
em a
nd w
e w
ill w
ork
as a
gro
up to
put
the
step
s in
ord
er.
Drug
Dist
ribu
tion
Sy
stem
Ste
ps
Not
e to
Tra
iner
:La
bel t
he fl
ip c
hart.
Use
the
pre-
prep
ared
‘d
rug
dist
ribut
ion
syst
em
step
s’ a
t the
bac
k of
this
m
anua
l on
page
47,
A
nnex
A.
Han
d ou
t eac
h st
ep to
a
diffe
rent
par
ticip
ant.
Ask
the
parti
cipa
nts
to re
ad
out t
heir
step
to th
e gr
oup.
Re
fer t
hem
to p
age
12.
Not
e to
Tra
iner
: A
sk th
is fi
rst p
artic
ipan
t to
com
e an
d pu
t the
ir st
ep o
n th
e fli
p ch
art a
t the
fron
t of
the
room
.
Pr
ocee
d to
put
up
all s
teps
in th
e sy
stem
by
aski
ng p
artic
ipan
ts to
dec
ide
the
corr
ect o
rder
and
then
pla
ce th
eir s
teps
on
the
flip
char
t.
Yo
u m
ay n
eed
to e
ncou
rage
/gui
de p
artic
ipan
ts to
the
corr
ect o
rder
.
O
nce
finis
hed,
you
sho
uld
have
the
step
s pl
aced
as
belo
w.
D
raw
arr
ows
betw
een
each
ste
p to
sho
w th
e flo
w o
f the
sys
tem
.
Step
2: A
SK:
Who
thin
ks th
ey h
ave
the
first
ste
p in
the
syst
em?
1415
Trainer Manual - HCM 02Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
sTo
pic
1: D
rug
Dis
trib
utio
n Sy
stem
and
For
ms
Step
3: E
XPLA
IN:
The
drug
dis
tribu
tion
syst
em m
ay h
ave
slig
htly
diff
eren
t ste
ps in
you
r Hea
lth S
ub-
Dis
trict
, or i
n di
ffere
nt p
arts
in U
gand
a. T
his
is o
kay.
The
pur
pose
of t
his
exer
cise
is
to h
ighl
ight
that
dru
g di
strib
utio
n fo
llow
s a
flow
of a
ctiv
ities
and
that
ther
e ar
e m
any
diffe
rent
peo
ple
and
orga
niza
tions
invo
lved
. If
we
are
able
to th
ink
of th
e w
hole
dr
ug d
istri
butio
n sy
stem
, we
are
bette
r abl
e to
und
erst
and
the
impo
rtanc
e of
our
ro
le in
kee
ping
the
syst
em o
n tra
ck.
Step
5: E
XPLA
IN:
W
e kn
ow th
at th
ere
are
man
y is
sues
that
can
pre
vent
dru
gs fr
om g
ettin
g to
you
r he
alth
cen
tre.
Th
ese
are
issu
es s
uch
as n
atio
nal o
r Dis
trict
leve
l sto
ck-o
ut o
f dru
gs, t
oo li
ttle
fund
ing
from
the
gove
rnm
ent t
o bu
y dr
ugs,
and
per
haps
eve
n dr
ugs
‘wal
king
aw
ay’ a
t diff
eren
t poi
nts
in th
e dr
ug d
istri
butio
n sy
stem
.
An
d w
e kn
ow th
at th
ere
is o
ften
little
you
can
do
abou
t the
se is
sues
.
Bu
t wha
t we
have
hea
rd fr
om th
e M
inis
try o
f Hea
lth, N
MS,
and
the
Dis
trict
is
that
mor
e in
form
atio
n an
d tim
ely
info
rmat
ion
is n
eede
d fro
m h
ealth
cen
tres
to
unde
rsta
nd b
ette
r how
dru
gs a
re u
sed,
esp
ecia
lly in
hea
lth c
entre
II a
nd II
Is.
S
o, y
ou p
lay
an im
porta
nt ro
le in
pro
vidi
ng a
ccur
ate
info
rmat
ion
and
timel
y up
date
s to
hel
p th
e dr
ug d
istri
butio
n sy
stem
wor
k w
ell a
t you
r hea
lth c
entre
.
If
you
keep
you
r par
t of t
he ‘t
rain
’ on
track
, it w
ill he
lp th
e w
hole
sys
tem
.
1) D
istr
ict
Hea
lth
Off
ice
(DH
O) r
ecei
ves
drug
s
from
the
Nat
ion
al M
edic
al S
tore
s (N
MS)
2) H
ealt
h S
ub-D
istr
ict
(HSD
) rec
eive
s dr
ugs
from
the
DHO
4) H
ealt
h ce
ntr
e II/IIIs
rec
eive
dru
gs f
rom
hea
lth
cen
tre
IVs
5) D
rugs
are
rec
eive
d at
the
hea
lth
cen
tre
and
ente
red
on a
Sto
ck C
ard
6) D
rugs
are
pre
scri
bed,
giv
en t
o pa
tien
ts, a
nd
reco
rded
on
the
out-
pati
ent
depa
rtm
ent
regi
ster
7) T
he
HSD
/ h
ealt
h ce
ntr
e IV
is n
otif
ied
when
ther
e ar
e st
ock-
outs
3) H
ealt
h Ce
ntr
e IV
s re
ceiv
e dr
ugs
from
the
HSD
Not
e to
Tra
iner
: P
artic
ipan
ts m
ay d
escr
ibe
slig
htly
diff
eren
t ver
sion
s of
the
drug
dis
tribu
tion
syst
em d
epen
ding
on
how
dru
gs a
re d
eliv
ered
in th
eir D
istri
ct o
r Hea
lth S
ub-
Dis
trict
. Th
is is
oka
y.
If
ther
e is
dis
agre
emen
t or d
iscu
ssio
n ab
out t
he s
teps
, you
may
wan
t to
expl
ain
as b
elow
.
Step
4: A
SK:
Thin
k ab
out y
our r
ole
as a
n in
-cha
rge.
Wha
t ste
ps o
n pa
ge 12
in th
e dr
ug
dist
ribut
ion
syst
em a
re y
ou in
volv
ed w
ith?
Not
e to
Tra
iner
: P
artic
ipan
ts s
houl
d pi
ck o
ut th
e St
eps
4 - 7
.
Th
ese
are
step
s th
at h
appe
n at
the
heal
th c
entre
.
G
uide
par
ticip
ants
to s
elec
ting
thes
e st
eps
by e
xpla
inin
g th
at th
ey a
re
invo
lved
with
the
step
s th
at h
appe
n at
thei
r hea
lth c
entre
.
1617Trainer Manual - HCM 02
Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
sTo
pic
1: D
rug
Dis
trib
utio
n Sy
stem
and
For
ms
3. P
rinci
ples
– T
he d
rug
dist
ribut
ion
syst
em
15
min
utes
Trai
ning
Ste
ps
Step
1: E
XPLA
IN:
Let’s
thin
k ab
out t
hese
ste
ps th
at y
ou a
re in
volv
ed w
ith.
4. P
rinci
ples
– T
he O
PD R
egis
ter
5 m
inut
es
Trai
ning
Ste
ps
Step
1: E
XPLA
IN:
Th
e O
PD re
gist
er is
an
impo
rtant
form
that
sho
uld
be c
ompl
eted
for a
ll pa
tient
s th
at v
isit
the
heal
th c
entre
.
As
par
t of o
ur re
sear
ch s
tudy
, you
will
rece
ive
a ne
w v
ersi
on o
n th
e O
PD re
gist
er
that
hel
ps y
ou k
eep
track
of t
he n
umbe
r of f
ever
s an
d th
e re
sults
of R
DT.
Th
is w
ill he
lp y
ou k
eep
track
of t
he n
umbe
r of p
atie
nts
with
mal
aria
atte
ndin
g yo
ur h
ealth
cen
tre.
You
will
be ta
ught
how
to u
se th
is re
gist
er.
Yo
u w
ill al
so le
arn
mor
e ab
out t
he O
PD re
gist
er in
the
HCM
03:
Info
rmat
ion
Man
agem
ent m
odul
e. F
or to
day’s
act
iviti
es, t
here
are
sam
ple
OPD
regi
ster
s in
clud
ed in
you
r man
ual t
o he
lp u
s w
ith c
ompl
etin
g th
e St
ock
Card
.
Th
ese
regi
ster
s ar
e in
you
r Lea
rner
Man
ual o
n pa
ges
43 -
45.
Th
roug
hout
toda
y’s tr
aini
ng w
e w
ill be
talk
ing
abou
t the
sup
ply
man
agem
ent o
f dr
ugs
for m
alar
ia, s
peci
fic a
rtem
ethe
r lum
efan
trine
, AL –
the
first
line
trea
tmen
t fo
r unc
ompl
icat
ed m
alar
ia in
Uga
nda.
You
may
kno
w th
is d
rug
as C
oarte
m o
r Lu
mar
tem
.
In
this
trai
ning
, we
use
the
nam
e Co
arte
m.
5. P
rinci
ples
– T
he S
tock
Car
d
5 m
inut
es
Trai
ning
Ste
ps
Step
1: A
SK:
Who
can
tell
me
wha
t the
Sto
ck C
ard
is a
nd w
hat i
t’s u
sed
for?
Not
e to
Tra
iner
: P
oint
to th
e st
eps
in g
rey/
pink
pre
view
ed o
n pa
ge 14
from
the
diag
ram
on
the
wal
l/fli
p ch
art.
Not
e to
Tra
iner
: A
sk fo
r an
answ
er fr
om p
artic
ipan
ts.
Refe
r the
m to
pag
e 14
.
Yo
u ca
n w
rite
key
wor
ds fo
r res
pons
es o
n th
e fli
p ch
art.
Step
2:
ACT
IVIT
Y B
– Pe
rson
al e
xper
ienc
es w
ith d
rug
dist
ribut
ion
Act
ivity
Ste
ps
1) D
IVID
E pa
rtici
pant
s in
to fo
ur g
roup
s. R
efer
them
to p
age
13 in
thei
r man
ual.
2) A
SSIG
N s
teps
4, 5
, 6, 7
of t
he d
rug
dist
ribut
ion
cycl
e to
eac
h gr
oup.
3) A
SK e
ach
grou
p to
thin
k ab
out t
heir
own
expe
rienc
es w
ith th
is s
tep.
4) E
XPLA
IN -
Dra
w o
n yo
ur o
wn
expe
rienc
es a
s yo
u di
scus
s to
geth
er w
ith
colle
ague
s in
you
r gro
up a
bout
how
you
can
do
the
step
wel
l and
the
posi
tive
outc
omes
of d
oing
the
step
wel
l.
5) G
IVE
each
gro
up 4
min
utes
to d
iscu
ss.
6) F
ACI
LITA
TE fe
edba
ck to
the
grou
p.
7) R
ECO
RD re
spon
ses
to e
ach
step
on
the
pre-
prep
ared
flip
cha
rt us
ing
colu
mns
as
belo
w.
8) L
IMIT
feed
back
for e
ach
step
to 2
min
utes
onl
y.
How
to
do it
wel
l
- - - -
Posi
tive
out
com
es
- - - -
Step
3: E
XPLA
IN:
Now
let’s
look
at t
hese
ste
ps a
nd th
e re
quire
d fo
rms
in d
etai
l inc
ludi
ng th
e O
ut
Patie
nt D
epar
tmen
t (O
PD) R
egis
ter a
nd th
e St
ock
Card
Ord
er F
orm
.
1819
Trainer Manual - HCM 02Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
sTo
pic
1: D
rug
Dis
trib
utio
n Sy
stem
and
For
ms
Step
2: E
XPLA
IN:
Th
e St
ock
Card
is a
form
use
d to
kee
p tra
ck o
f the
dru
g an
d su
pplie
s th
at a
re
rece
ived
and
use
d at
the
heal
th c
entre
.
Th
e St
ock
Card
hel
ps u
s to
cal
cula
te th
e Av
erag
e M
onth
ly C
onsu
mpt
ion,
M
inim
um S
tock
Leve
l and
Max
imum
Sto
ck Le
vel f
or e
ach
drug
or s
uppl
y.
O
ne S
tock
Car
d is
fille
d ou
t for
eac
h dr
ug o
r sup
ply.
6. P
ract
ice
– Th
e St
ock
Card
30
min
utes
Trai
ning
Ste
ps
Not
e to
Tra
iner
:Fo
r the
follo
win
g ac
tivity
, div
ide
parti
cipa
nts
into
two
grou
ps.
You
and
your
co-
train
er w
ill e
ach
lead
a g
roup
thro
ugh
the
activ
ity.
Refe
r par
ticip
ants
to p
age
15.
Step
3: A
SK:
How
ofte
n is
the
Stoc
k Ca
rd c
ompl
eted
?
����
����
��
� ��
���
���
����
com
plet
ed e
very
day
or a
t le
ast
ever
y w
eek
.
Not
e to
Tra
iner
:A
sk fo
r an
answ
er
from
par
ticip
ants
.
Yo
u ca
n w
rite
key
wor
ds fr
om
resp
onse
s on
the
flip
char
t. R
efer
pa
rtici
pant
s to
pa
ge 14
.
Step
1:
ACT
IVIT
Y C
– Fi
lling
out
a S
tock
Car
d
Act
ivity
Ste
ps
1) RE
FER
part
icip
ants
to th
e sa
mpl
e st
ock
card
in th
eir m
anua
ls –
pag
e 41
.
2) E
XPLA
IN -
Lets
pra
ctic
e fil
ling
out t
he S
tock
Car
d. T
here
is a
sam
ple
Stoc
k Ca
rd in
you
r Lea
rner
Man
ual o
n pa
ge 4
1. Y
ou’ll
see
that
som
e of
the
sect
ions
at
the
top
are
com
plet
ed (S
ee Tr
aine
r Ann
ex C
).
3) R
EVIE
W (q
uick
ly) t
he c
ompl
eted
sec
tions
, but
spe
nd n
o m
ore
than
one
m
inut
e.
4) E
XPLA
IN -
I will
read
out
som
e ac
tions
and
we
will
also
take
som
e in
form
atio
n fro
m o
ur s
ampl
e O
PD re
gist
ers
(See
Trai
ner A
nnex
D).
For t
he fi
rst a
ctio
n: O
n Fe
brua
ry 1s
t, 20
10, y
ou re
ceiv
e 30
0 do
ses
of
Coar
tem
12 ta
b pa
ckag
es fr
om th
e N
MS
bi-m
onth
ly d
istri
butio
n to
hea
lth
cent
res.
The
vou
cher
num
ber i
s 00
39.
5) A
SK p
artic
ipan
ts h
ow th
is s
houl
d be
reco
rded
on
the
Stoc
k Ca
rd.
Whe
n th
ere
is c
onse
nsus
on
the
corr
ect w
ay to
reco
rd, a
sk p
artic
ipan
ts to
reco
rd it
on
thei
r Sto
ck C
ard.
For t
he n
ext a
ctio
n: W
e ne
ed to
kno
w w
hich
dru
gs a
nd h
ow m
uch
of e
ach
drug
wer
e di
strib
uted
to p
atie
nts.
We
can
find
this
info
rmat
ion
in th
e O
PD
regi
ster
.
(S
ee Tr
aine
r Ann
ex D
).
6) A
SK p
artic
ipan
ts to
turn
to th
e sa
mpl
e O
PD re
gist
ers
on p
age
43 o
f the
ir m
anua
ls a
nd c
ount
how
man
y Co
arte
m 12
tab
pack
ages
wer
e is
sued
for t
he
wee
k of
1 Fe
brua
ry to
7 F
ebru
ary.
7) W
hen
ther
e is
con
sens
us o
n th
e to
tal C
oarte
m 12
tab
pack
ages
issu
ed, a
sk
parti
cipa
nts
how
to re
cord
this
on
thei
r Sto
ck C
ard.
8) W
hen
ther
e is
con
sens
us o
n th
e co
rrec
t way
to re
cord
, ask
par
ticip
ants
to
reco
rd it
on
thei
r Sto
ck C
ard,
incl
udin
g ca
lcul
atin
g th
e ‘b
alan
ce o
n ha
nd’.
9) E
XPLA
IN -
The
‘bal
ance
on
hand
’ is
the
tota
l am
ount
of t
he d
rug
left
in s
tock
af
ter t
he d
rug
has
been
issu
ed to
pat
ient
s.
For t
he n
ext a
ctio
n: H
ow m
any
Coar
tem
12 ta
b pa
ckag
es w
ere
issu
ed fo
r th
e w
eek
of 8
Feb
ruar
y to
14 F
ebru
ary?
(S
ee Tr
aine
r Ann
ex E
– C
ompl
eted
Sto
ck C
ard
for 1
2 ta
b)
10) A
SK p
artic
ipan
ts h
ow to
reco
rd th
is a
nd w
hen
ther
e is
con
sens
us, a
sk
parti
cipa
nts
to re
cord
it o
n th
eir S
tock
Car
d.
2021
Trainer Manual - HCM 02Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
sTo
pic
1: D
rug
Dis
trib
utio
n Sy
stem
and
For
ms
For t
he n
ext a
ctio
n: O
n 18
Feb
ruar
y, y
ou d
ecid
ed to
take
a p
hysi
cal c
ount
of
all t
he C
oarte
m 12
tab
pack
ages
left
in y
our s
tore
. Yo
u co
unt a
nd s
ee th
at
ther
e ar
e 23
0 do
ses
left.
11)
ASK
par
ticip
ants
how
to re
cord
this
and
whe
n th
ere
is c
onse
nsus
, ask
pa
rtici
pant
s to
reco
rd it
on
thei
r Sto
ck C
ard.
12) C
HEC
K if
all p
artic
ipan
ts h
ave
com
plet
ed th
eir S
tock
Car
d co
rrec
tly.
Ask
pa
rtici
pant
s to
hel
p th
e pe
rson
nex
t to
them
if n
eede
d.
Step
2: E
XPLA
IN:
W
e ca
n us
e th
is to
det
erm
ine
how
man
y dr
ugs
we
are
usin
g in
a m
onth
at t
he
heal
th c
entre
. W
e ca
ll th
is th
e Av
erag
e M
onth
ly C
onsu
mpt
ion.
The
ave
rage
m
onth
ly c
onsu
mpt
ion
also
hel
ps u
s to
det
erm
ine
how
man
y dr
ugs
we
shou
ld
keep
in s
tock
. Th
e av
erag
e m
onth
ly c
onsu
mpt
ion
is th
e av
erag
e co
nsum
ptio
n of
a
drug
ove
r a th
ree
mon
th p
erio
d.
Th
e M
inim
um S
tock
Leve
l is
the
low
est a
mou
nt o
f eac
h dr
ug th
at s
houl
d be
in
stoc
k at
the
heal
th c
entre
. Ke
epin
g a
min
imum
sto
ck le
vel h
elps
to p
reve
nt s
tock
-ou
ts.
The
Min
istry
of H
ealth
reco
mm
ends
a m
inim
um s
tock
leve
l of t
wo-
times
the
aver
age
mon
thly
con
sum
ptio
n.
Th
e M
axim
um S
tock
Leve
l is
the
high
est a
mou
nt o
f eac
h dr
ug th
at s
houl
d be
in
stoc
k at
the
heal
th c
entre
. Ke
epin
g a
max
imum
sto
ck le
vel h
elps
to p
reve
nt a
n ac
cum
ulat
ion
of d
rugs
that
mig
ht s
poil
or e
xpire
bef
ore
they
can
be
used
. Th
e M
inis
try o
f Hea
lth re
com
men
ds a
max
imum
sto
ck le
vel o
f fiv
e-tim
es th
e av
erag
e m
onth
ly c
onsu
mpt
ion.
W
e un
ders
tand
that
it is
diff
icul
t to
calc
ulat
e th
e m
inim
um s
tock
leve
l and
the
max
imum
sto
ck le
vels
of d
rugs
at y
our h
ealth
cen
tres
beca
use
you
have
not
be
en re
ceiv
ing
drug
s re
gula
rly.
How
ever
, as
you
begi
n to
rece
ive
drug
s m
ore
regu
larly
ove
r the
com
ing
mon
ths,
you
’ll be
abl
e to
cal
cula
te y
our a
vera
ge
mon
thly
con
sum
ptio
n, m
inim
um s
tock
leve
l, an
d m
axim
um s
tock
leve
l. It
is
impo
rtant
to k
eep
track
of t
his
info
rmat
ion
in o
rder
to in
form
the
Dis
trict
of t
he
requ
irem
ents
at y
our h
ealth
cen
tre.
Fo
r our
act
iviti
es to
day,
we
have
a s
ampl
e St
ock
Card
that
has
bee
n co
mpl
eted
fo
r a th
ree
mon
th p
erio
d. L
et’s
use
this
to d
eter
min
e th
e av
erag
e m
onth
ly
cons
umpt
ion,
min
imum
sto
ck le
vel,
and
max
imum
sto
ck le
vel.
Thi
s sa
mpl
e St
ock
Card
is o
n pa
ge 4
7 of
you
r Lea
rner
Man
ual.
Step
3: E
XPLA
IN:
To
cal
cula
te th
e av
erag
e m
onth
ly c
onsu
mpt
ion,
we
add
up th
e to
tal d
rugs
issu
ed
to p
atie
nts
from
the
‘Qua
ntity
Out
’ col
umn
for a
per
iod
of th
ree
mon
ths
and
divi
de
this
tota
l by
thre
e.
Not
e to
Tra
iner
:G
o to
you
r com
plet
ed s
tock
car
d on
pag
e 57
, Tra
iner
Ann
ex E
.
Parti
cipa
nts
have
a s
ampl
e St
ock
Card
on
page
47.
Not
e to
Tra
iner
:Re
ceiv
e re
spon
ses
from
the
grou
p.
If
parti
cipa
nts
are
stru
gglin
g w
ith th
e ca
lcul
atio
ns, e
xpla
in a
nd s
how
them
ho
w to
use
the
calc
ulat
or fu
nctio
n on
thei
r mob
ile.
W
hen
ther
e is
agr
eem
ent o
n th
e rig
ht a
nsw
er, r
ecor
d it
on th
e fli
p ch
art.
A
sk p
artic
ipan
ts to
reco
rd th
is a
nsw
er o
n th
eir s
ampl
e St
ock
Card
on
page
47.
Not
e to
Tra
iner
:W
hen
ther
e is
agr
eem
ent o
n th
e rig
ht a
nsw
er, r
ecor
d it
on th
e fli
p ch
art.
Step
4: A
SK:
Wha
t is
the
tota
l of C
oarte
m 12
tab
pack
s is
sued
for t
he m
onth
s of
Feb
ruar
y, M
arch
an
d Ap
ril 2
011?
Step
5: A
SK:
Wha
t is
this
tota
l div
ided
by
3?
Step
6: E
XPLA
IN:
This
is th
e av
erag
e m
onth
ly c
onsu
mpt
ion.
Hav
e yo
u w
ritte
n th
is in
you
r man
uals
?
2223
Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
s
Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
s
Step
9: A
SK:
Why
is it
impo
rtant
to c
alcu
late
the
min
imum
and
max
imum
sto
ck le
vels
?
Step
7: E
XPLA
IN:
To c
alcu
late
the
min
imum
sto
ck le
vel,
we
mul
tiply
the
aver
age
mon
thly
con
sum
ptio
n by
2.
Wha
t is
the
min
imum
sto
ck le
vel f
or C
oarte
m 12
tab
pack
?
Step
8: E
XPLA
IN:
To c
alcu
late
the
max
imum
sto
ck le
vel,
we
mul
tiply
the
aver
age
mon
thly
co
nsum
ptio
n by
5.
Wha
t is
the
min
imum
sto
ck le
vel f
or C
oarte
m 12
tab
pack
?
Step
10:
EXP
LAIN
:
The
min
imum
and
max
imum
sto
ck le
vels
hel
p us
to d
eter
min
e ho
w m
uch
of e
ach
drug
to o
rder
. W
hen
the
stoc
k ha
s re
ache
d th
e m
inim
um s
tock
leve
l, w
e sh
ould
pl
ace
an o
rder
for m
ore
drug
s. T
he o
rder
pla
ced
shou
ld n
ot e
xcee
d th
e m
axim
um
stoc
k le
vel.
St
ep 2
: EXP
LAIN
:
Ther
e ar
e fo
ur c
ompl
eted
sam
ple
Stoc
k Ca
rds
in y
our L
earn
er M
anua
l on
page
s 49
to
55
for e
ach
of th
e fo
ur w
eigh
t-bas
ed d
oses
of C
oarte
m. T
here
is a
lso
a sa
mpl
e O
rder
For
m th
at h
as b
een
parti
ally
com
plet
ed.
We’
ll us
e th
ese
for t
he fo
llow
ing
activ
ity.
(Trai
ner A
nnex
F 1
- F4)
.
Not
e to
Tra
iner
:W
hen
ther
e is
agr
eem
ent o
n th
e rig
ht a
nsw
er, r
ecor
d it
on th
e fli
p ch
art.
Ask
pa
rtici
pant
s to
reco
rd th
is a
nsw
er th
eir s
ampl
e St
ock
Card
.
Not
e to
Tra
iner
:W
hen
ther
e is
agr
eem
ent o
n th
e rig
ht a
nsw
er, r
ecor
d it
on th
e fli
p ch
art.
Ask
pa
rtici
pant
s to
reco
rd th
is a
nsw
er o
n th
eir s
ampl
e St
ock
Card
.
Not
e to
Tra
iner
:A
sk fo
r res
pons
es fr
om th
e pa
rtici
pant
s. E
xpla
in th
e fo
llow
ing
if th
e an
swer
is
not
pro
vide
d.
7. P
rinci
ples
– T
he O
rder
For
m
5 m
inut
es
Trai
ning
Ste
ps
Step
1: E
XPLA
IN:
N
ow it
’s tim
e to
look
at t
he O
rder
For
m.
This
is a
new
form
from
the
Min
istry
of
Hea
lth.
It is
use
d to
requ
est s
uppl
ies
from
the
Nat
iona
l Med
ical
Sto
res.
In
the
new
‘pus
h sy
stem
’ of d
rug
dist
ribut
ion,
you
hav
e no
t bee
n or
derin
g fo
r su
pplie
s –
you
have
bee
n re
ceiv
ing
pre-
dete
rmin
ed s
uppl
y de
liver
ies
from
the
Nat
iona
l Med
ical
Sto
res
ever
y tw
o m
onth
s. A
s pa
rt of
this
ACT
PRI
ME
rese
arch
st
udy,
we
wou
ld li
ke y
ou to
sta
rt us
ing
the
Ord
er F
orm
to o
rder
for C
oarte
m a
nd
RDTs
.
As
par
t of o
ur re
sear
ch s
tudy
, we
are
supp
ortin
g th
e H
ealth
Sub
-Dis
trict
and
the
Dis
trict
to e
nsur
e th
at th
e or
ders
that
you
pla
ce fo
r Coa
rtem
and
RD
Ts a
re fi
lled
for
the
ten
heal
th c
entre
s en
rolle
d in
our
stu
dy.
H
owev
er, o
rder
s ca
nnot
be
fille
d if
the
Hea
lth S
ub-D
istri
ct a
nd th
e D
istri
ct a
re n
ot
awar
e of
the
Coar
tem
and
RD
Ts n
eede
d at
you
r hea
lth c
entre
. Th
is is
why
you
pl
ay a
ver
y im
porta
nt ro
le in
kee
ping
the
drug
dis
tribu
tion
syst
em o
n tra
ck b
y co
mpl
etin
g th
e O
PD R
egis
ter,
Stoc
k Ca
rd a
nd O
rder
For
m a
ccur
atel
y an
d on
tim
e.
8. P
ract
ice
– Th
e O
rder
For
m
10
min
utes
Trai
ning
Ste
ps
Step
1: E
XPLA
IN:
Whe
n yo
u fin
d th
at y
our d
rug
supp
ly is
get
ting
low
and
ther
e ar
e no
t eno
ugh
drug
s to
last
unt
il th
e ne
xt s
ched
uled
NM
S bi
-mon
thly
dis
tribu
tion,
you
sho
uld
requ
est f
or
addi
tiona
l dru
gs fr
om th
e H
ealth
Sub
-Dis
trict
. To
plac
e th
is o
rder
, you
nee
d to
fill
out
four
cop
ies
of th
e O
rder
For
m. T
his
next
act
ivity
is a
n op
portu
nity
to p
ract
ice
fillin
g ou
t the
Ord
er F
orm
on
page
57
and
59.
2425
Trainer Manual - HCM 02Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
sTo
pic
1: D
rug
Dis
trib
utio
n Sy
stem
and
For
ms
Step
3: E
XPLA
IN:
Th
e St
ock
Card
for y
ello
w C
oarte
m (6
tab
dose
) on
page
49,
sho
ws
the
stoc
k is
ab
ove
the
max
imum
sto
ck le
vel.
(Trai
ner A
nnex
F 1)
Th
e St
ock
Card
for b
lue
Coar
tem
(12
tab
dose
) on
page
51,
show
s th
e st
ock
is
belo
w th
e m
inim
um s
tock
leve
l. (Tr
aine
r Ann
ex F
2)
Th
e St
ock
Card
for g
reen
Coa
rtem
(18
tab
dose
) on
page
53,
sho
ws
the
stoc
k is
eq
ual t
o th
e m
inim
um s
tock
leve
l. (Tr
aine
r Ann
ex F
3)
Th
e St
ock
Card
for b
row
n Co
arte
m (2
4 ta
b do
se) o
n pa
ge 5
5, s
how
s th
e st
ock
is
alm
ost a
t the
min
imum
sto
ck le
vel.
(Trai
ner A
nnex
F 4
)
Step
5: E
XPLA
IN:
We
shou
ld p
lace
an
orde
r for
blu
e, g
reen
, and
bro
wn
Coar
tem
. W
e sh
ould
not
pl
ace
an o
rder
for y
ello
w C
oarte
m a
t thi
s po
int b
ecau
se w
e do
not
wan
t to
exce
ed
the
max
imum
sto
ck le
vel.
Step
9: E
XPLA
IN:
We
reco
rd ‘7
’ on
the
Ord
er F
orm
und
er ‘Q
uant
ity O
rder
ed’
Step
11:
EXP
LAIN
:
We
will
not b
e co
mpl
etin
g th
e ’p
ack
unit
pric
e’ a
nd ‘t
otal
cos
t’ se
ctio
ns o
n th
e O
rder
Fo
rm fo
r thi
s ac
tivity
. Al
so, f
or n
ow, y
ou d
o no
t nee
d to
com
plet
e th
ese
whe
n yo
u ar
e pl
acin
g yo
ur o
rder
with
the
Hea
lth S
ub D
istri
ct.
How
ever
, in
the
futu
re y
ou m
ay
be a
sked
to c
ompl
ete
thes
e se
ctio
ns b
y th
e M
inis
try o
f Hea
lth.
You
will
be in
form
ed
whe
n yo
u ne
ed to
sta
rt co
mpl
etin
g th
ese
sect
ions
.
Step
10:
ASK
:
Plea
se c
ompl
ete
the
sam
ple
orde
r for
m, o
n pa
ge 5
9 of
you
r man
uals
.
Step
4: E
XPLA
IN:
Whi
ch o
f the
se d
osag
es o
f Coa
rtem
will
you
plac
e an
ord
er fo
r?
Step
6: E
XPLA
IN:
How
do
we
calc
ulat
e ho
w m
uch
of e
ach
Coar
tem
dos
e sh
ould
we
orde
r?
Step
8:
Step
7: E
XPLA
IN:
We
shou
ld o
rder
the
max
imum
sto
ck le
vel m
inus
the
amou
nt o
f the
dru
g w
e ha
ve in
st
ore.
Not
e to
Tra
iner
:G
athe
r mul
tiple
resp
onse
s fro
m p
artic
ipan
ts, t
hen
expl
ain
the
follo
win
g.
Not
e to
Tra
iner
:G
athe
r mul
tiple
resp
onse
s fro
m p
artic
ipan
ts, t
hen
expl
ain
the
follo
win
g.
Not
e to
Tra
iner
:Fo
r the
follo
win
g ac
tivity
, div
ide
parti
cipa
nts
into
two
grou
ps.
Yo
u an
d yo
ur c
o-tra
iner
will
eac
h le
ad a
gro
up th
roug
h th
e ac
tivity
. Ref
er
them
to p
age
21.
ACT
IVIT
Y D
– C
ompl
etin
g th
e or
der f
orm
for 1
2 (B
lue)
coa
rtem
Act
ivity
Ste
ps
1) EX
PLA
IN:
Let’s
try
com
plet
ing
the
Ord
er F
orm
on
page
57
(Trai
ner A
nnex
H)
for t
he 12
-tab
(blu
e) C
oarte
m d
ose.
2) E
XPLA
IN: I
f we
have
55
dose
s in
sto
ck a
nd o
ur m
axim
um s
tock
leve
l is
245,
ho
w m
uch
shou
ld w
e or
der?
3) S
HO
W th
e ca
lcul
atio
n on
the
flip
char
t and
inst
ruct
par
ticip
ants
to c
ompl
ete
the
calc
ulat
ion
in th
e sp
ace
prov
ided
on
the
sam
ple
Ord
er F
orm
on
page
57.
(Tr
aine
r Ann
ex H
)
=
245
– 55
=190
dos
es o
r pac
ks
4) E
XPLA
IN: C
oarte
m c
omes
in b
oxes
of 3
0 pa
cks
and
each
pac
k ha
s 12
tabs
of
Coar
tem
. Thi
s is
the
‘pac
k un
it’ in
dica
ted
on th
e O
rder
For
m.
5) E
XPLA
IN: T
ake
the
amou
nt y
ou n
eed,
190
dose
s an
d di
vide
it b
y 30
190
dose
s /3
0 bo
xes
= 6.
33
6) E
XPLA
IN: A
lway
s ro
und
the
num
ber u
p so
that
you
rece
ive
anot
her f
ull b
ox o
f 30
to m
eet y
our r
equi
rem
ents
.
2627Trainer Manual - HCM 02
Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
sTo
pic
1: D
rug
Dis
trib
utio
n Sy
stem
and
For
ms
Not
e to
Tra
iner
: G
ive
parti
cipa
nts
5-7
min
utes
to c
ompl
ete
the
Ord
er F
orm
. O
nce
com
plet
e,
ask
parti
cipa
nts
to s
hare
how
they
com
plet
ed th
e fo
rm.
See
if th
ere
is
cons
ensu
s am
ongs
t par
ticip
ants
and
cla
rify
any
diffe
renc
es.
Not
e to
Tra
iner
: A
sk p
artic
ipan
ts to
sha
re th
eir t
houg
hts
and
expe
rienc
es w
ith th
e gr
oup.
Pa
rtici
pant
s m
ay fe
el re
lieve
d th
at th
ey n
ow k
now
how
to c
ompl
ete
thes
e fo
rms.
O
r par
ticip
ants
may
feel
ove
rwhe
lmed
with
all
of th
e ne
w in
form
atio
n.
Bo
th o
f the
se re
actio
ns a
re o
kay.
Not
e to
Tra
iner
: A
sk p
artic
ipan
ts fo
r res
pons
es.
Onc
e yo
u ha
ve c
olle
cted
a fe
w re
spon
ses,
di
rect
par
ticip
ants
to th
e ‘C
heck
list’
in th
eir L
earn
er M
anua
l on
page
23.
Ex
plai
n to
par
ticip
ants
that
ther
e is
a d
uplic
ate
copy
of t
his
chec
klis
t in
Ann
ex
10 o
n pa
ge 6
5 of
thei
r man
uals
so
that
they
can
pin
up
one
copy
at t
heir
heal
th c
entre
to h
elp
them
eac
h tim
e th
ey a
re c
ompl
etin
g th
e fo
rms.
Step
2: E
XPLA
IN:
You
shou
ld a
lway
s try
to c
ompl
ete
thes
e fo
rms
to th
e be
st o
f you
r abi
lity.
As
we
have
lear
ned
toda
y, yo
u pl
ay a
n im
porta
nt ro
le in
the
drug
dis
tribu
tion
syst
em.
Com
plet
ing
thes
e fo
rms
and
com
mun
icat
ing
the
info
rmat
ion
with
the
Hea
lth S
ub-
Dis
trict
and
Dis
trict
is a
n im
porta
nt fi
rst s
tep
in k
eepi
ng th
e dr
ug d
istri
butio
n sy
stem
on
trac
k.
Step
12:
ACT
IVIT
Y E
– Co
mpl
etin
g th
e or
der f
orm
for b
row
n (18
) and
gre
en (2
4) C
oart
em
Act
ivity
Ste
ps
1) D
IVID
E: T
he g
roup
in p
airs
2) C
ompl
ete
the
orde
r fro
m fo
r the
18
tab
(bro
wn)
and
24
tab
(gre
en d
oses
) of
Coa
rtem
.
9. D
iscu
ssio
n
10
min
utes
Trai
ning
Ste
ps
Step
1: A
SK:
Doe
s an
yone
wan
t to
shar
e th
eir r
eact
ions
to fi
lling
in th
e fo
rms?
10. P
lann
ing
10
min
utes
Trai
ning
Ste
ps
Step
1: A
SK:
Let u
s de
velo
p a
chec
klis
t to
help
rem
embe
r how
to c
ompl
ete
the
Stoc
k Ca
rd
and
the
Ord
er F
orm
. W
hat a
re s
ome
of th
e th
ings
we
need
to re
mem
ber w
hen
com
plet
ing
thes
e fo
rms?
Stoc
k Ca
rd C
heck
list
� T
here
is a
Sto
ck C
ard
for e
ach
drug
at t
he h
ealth
cen
tre
� B
e su
re to
com
plet
e a
Stoc
k Ca
rd fo
r Coa
rtem
and
RD
Ts
� C
ompl
ete
the
Stoc
k Ca
rd e
ach
time
drug
s ar
e re
ceiv
ed a
t the
hea
lth c
entre
� C
ompl
ete
the
Stoc
k Ca
rd a
t lea
st w
eekl
y to
det
erm
ine
how
man
y dr
ugs
you
have
left
in s
tock
� A
lway
s re
mem
ber t
o co
mpl
ete
the
‘Bal
ance
on
hand
’
� C
ompl
ete
a ph
ysic
al c
ount
of t
he d
rugs
left
in s
tock
eve
ry m
onth
Aver
age
Mon
thly
Con
sum
ptio
n=
From
the
OPD
regi
ster
, cou
nt th
e to
tal d
rugs
issu
ed o
ver a
thre
e m
onth
per
iod
and
divi
de b
y th
ree
Min
imum
sto
ck le
vel
= Av
erag
e m
onth
ly c
onsu
mpt
ion
X 2
Max
imum
sto
ck le
vel
= Av
erag
e m
onth
ly c
onsu
mpt
ion
X 5
2829Trainer Manual - HCM 02
Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
sTo
pic
1: D
rug
Dis
trib
utio
n Sy
stem
and
For
ms
Ord
er F
orm
Che
cklis
t
� C
ompl
ete
the
Ord
er F
orm
whe
n yo
u ha
ve re
ache
d th
e m
inim
um m
onth
ly
cons
umpt
ion
of C
oarte
m o
r RD
Ts a
nd y
ou n
eed
to p
lace
an
orde
r for
mor
e
� A
void
ord
erin
g m
ore
than
you
r max
imum
sto
ck le
vel
� A
lway
s co
mpl
ete
and
sign
the
‘Rec
eipt
dat
e’ w
hen
you
rece
ive
the
orde
r at
your
hea
lth c
entre
� C
ompl
ete
four
cop
ies
of th
e O
rder
For
m
� 1
copy
sta
ys a
t the
hea
lth c
entre
� 3
cop
ies
go to
the
Hea
lth S
ub-D
istri
ct
Qua
ntity
requ
ired
= M
axim
um s
tock
leve
l – b
alan
ce o
n ha
nd s
how
n on
the
Stoc
k Ca
rd
G
ettin
g dr
ugs
to y
our h
ealth
cen
tre is
like
mov
ing
a tra
in a
long
a tr
ack.
The
re
are
diffe
rent
par
ts th
at h
ave
to w
ork
toge
ther
to k
eep
the
train
– th
e dr
ugs
– on
tra
ck a
nd m
ovin
g to
you
r hea
lth c
entre
.
D
rug
dist
ribut
ion
follo
ws
a flo
w o
f act
iviti
es w
ith m
any
diffe
rent
peo
ple
and
orga
niza
tions
invo
lved
. Th
inki
ng o
f the
who
le d
rug
dist
ribut
ion
syst
em h
elps
to
keep
it o
n tra
ck.
In
-cha
rges
pla
y an
impo
rtant
role
in p
rovi
ding
acc
urat
e in
form
atio
n an
d tim
ely
upda
tes
to h
elp
the
drug
dis
tribu
tion
syst
em w
ork
wel
l at y
our h
ealth
cen
tre.
In
-cha
rges
are
invo
lved
in
- Re
ceiv
ing
drug
s
- En
terin
g on
the
stoc
k ca
rd
- Pr
escr
ibin
g an
d gi
ving
to p
atie
nts,
and
reco
rded
on
the
out-p
atie
nt
depa
rtmen
t reg
iste
r
- N
otify
ing
the
HSD
/hea
lth c
entre
IC w
hen
ther
e ar
e st
ock
outs
Th
e O
PD re
gist
er is
an
impo
rtant
form
that
sho
uld
be c
ompl
eted
for a
ll pa
tient
s th
at v
isit
the
heal
th c
entre
.
Th
e St
ock
Card
is a
form
use
d to
kee
p tra
ck o
f the
dru
g an
d su
pplie
s th
at a
re
rece
ived
and
use
d at
the
heal
th c
entre
.
Th
e St
ock
Card
hel
ps to
cal
cula
te th
e av
erag
e m
onth
ly c
onsu
mpt
ion,
min
imum
st
ock
leve
l and
max
imum
sto
ck le
vel f
or e
ach
drug
or s
uppl
y.
Th
e m
inim
um a
nd m
axim
um s
tock
leve
ls h
elp
to d
eter
min
e ho
w m
uch
of e
ach
drug
to o
rder
. W
hen
the
stoc
k ha
s re
ache
d th
e m
inim
um s
tock
leve
l, an
ord
er
for m
ore
drug
s sh
ould
be
plac
ed.
The
orde
r pla
ced
shou
ld n
ot e
xcee
d th
e m
axim
um s
tock
leve
l.
Co
mpl
etin
g th
ese
form
s an
d co
mm
unic
atin
g th
e in
form
atio
n w
ith th
e H
ealth
Sub
-Dis
trict
and
Dis
trict
is a
n im
porta
nt fi
rst s
tep
in k
eepi
ng th
e dr
ug
dist
ribut
ion
syst
em o
n tra
ck.
Sum
mar
y Bo
x –
Dru
g D
istr
ibut
ion
Syst
em &
For
ms
For r
efer
ence
for t
rain
ers
and
lear
ners
3031
Trainer Manual - HCM 02
Topi
c 1:
Dru
g D
istr
ibut
ion
Syst
em a
nd F
orm
s
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
TOPI
C 2:
KEE
PIN
G T
RACK
OF
DRU
G
DIS
TRIB
UTI
ON
ACT
IVIT
IES
To
tal T
ime:
75
min
utes
Purp
ose:
To in
trodu
ce p
artic
ipan
ts to
the
AD
DAT
and
how
it c
an b
e us
ed to
trac
k is
sues
in th
e dr
ug d
istri
butio
n sy
stem
.
Lear
ning
Out
com
es: B
y th
e en
d of
this
ses
sion
par
ticip
ants
will
:
1) Id
entif
y th
e ac
tiviti
es re
quire
d to
get
dru
gs fr
om th
e D
istri
ct o
r Hea
lth S
ub-
Dis
trict
to th
e he
alth
cen
tre
2) I
dent
ify c
halle
nges
and
sol
utio
ns to
com
plet
ing
drug
dis
tribu
tion
syst
em
activ
ities
3) B
e m
otiv
ated
to k
eep
track
of h
ealth
cen
tre le
vel a
ctiv
ities
in th
e dr
ug
dist
ribut
ion
syst
em
Mat
eria
ls re
quire
d:
Flip
cha
rt M
arke
rs
Tape
A
nnex
I, J,
K.
Trai
ning
met
hods
use
d:
Gro
up D
iscu
ssio
n P
ract
ice
Lec
ture
Page
25
3233
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Step
2: A
SK:
We
are
goin
g to
con
tinue
talk
ing
abou
t ‘re
d lig
hts’
and
‘gre
en li
ghts
’ for
the
rest
of
the
mod
ule.
We
are
refe
rrin
g to
the
red
and
gree
n lig
hts
on tr
affic
ligh
ts!
Step
4: A
SK:
Wha
t are
som
e of
the
prob
lem
s or
cha
lleng
es y
ou fa
ce?
Step
5: A
SK:
Is th
ere
anyt
hing
you
do
at y
our h
ealth
cen
tre to
kee
p tra
ck o
f the
se p
robl
ems
or
chal
leng
es?
Not
e to
Tra
iner
: A
s a
parti
cipa
nt d
escr
ibes
the
colo
ur o
f the
traf
fic li
ghts
, writ
e th
em o
n a
flipc
hart
as fo
llow
s:
Re
d lig
ht =
sto
p, d
o no
t mov
e
G
reen
ligh
t = g
o, m
ove
Ye
llow
ligh
t = g
o sl
owly,
mov
e sl
owly
Not
e to
Tra
iner
: W
rite
resp
onse
s on
a fl
ip c
hart.
Ref
er p
artic
ipan
ts to
follo
w a
long
on
page
26.
Not
e to
Tra
iner
: F
or th
is a
ctiv
ity y
ou w
ill b
e ha
ndin
g ou
t the
‘Dru
g Su
pply
Act
ivity
’ car
ds –
Tr
aine
r Ann
ex I;
hav
e th
ese
read
y.
Not
e to
Tra
iner
: W
rite
resp
onse
s on
a fl
ip c
hart.
Step
3: E
XPLA
IN:
D
rug
dist
ribut
ion
is ju
st li
ke th
is g
ame
– w
hen
thin
gs a
re w
orki
ng (g
reen
ligh
t),
the
syst
em a
t you
r hea
lth c
entre
mov
es fo
rwar
d an
d pa
tient
s re
ceiv
e th
e rig
ht
treat
men
t.
Bu
t whe
n yo
u ex
perie
nce
a bl
ock
in th
e sy
stem
(red
ligh
t), e
very
thin
g at
you
r he
alth
cen
tre s
tops
and
dru
gs a
re n
ot a
vaila
ble
to c
are
for y
our p
atie
nts.
Le
t’s th
ink
abou
t the
act
iviti
es y
ou d
o to
get
dru
gs fr
om th
e D
istri
ct o
r Hea
lth S
ub-
Dis
trict
to y
our h
ealth
cen
tre.
Step
1: E
XPLA
IN:
Ther
e is
a c
ase
stud
y in
you
r Lea
rner
Man
ual o
n pa
ge 2
6 th
at d
escr
ibes
a
situ
atio
n of
dru
g di
strib
utio
n in
a h
ealth
cen
tre.
First
, I w
ant t
o kn
ow if
this
si
tuat
ion
is fa
milia
r to
you
– ho
w it
com
pare
s w
ith y
our e
xper
ienc
e. T
hen,
we
will
read
the
case
stu
dy to
geth
er a
nd h
ighl
ight
all
of th
e ac
tiviti
es c
ompl
eted
to g
et
drug
s to
the
heal
th c
entre
.
1. In
trodu
ctio
n to
the
topi
c
15
min
utes
Trai
ning
Ste
ps
Step
1:
2. T
hink
ing
abou
t the
topi
c
15
min
utes
Trai
ning
Ste
ps
ACT
IVIT
Y F
– Re
d Li
ght,
Gre
en L
ight
Gam
e
Act
ivity
Ste
ps
1) G
roup
rem
ains
at t
heir
tabl
es.
2) W
hen
the
train
er s
ays
‘red
light
’, th
e pa
rtici
pant
s si
t dow
n.
3) W
hen
the
train
er s
ays
‘gre
en li
ght’,
par
ticip
ants
sta
nd u
p.
4) I
f par
ticip
ants
sit
dow
n w
hen
they
sho
uld
be s
tand
ing,
or s
tand
whe
n th
ey
shou
ld b
e si
tting
, the
y ar
e ou
t of t
he g
ame.
3435
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Step
4: E
XPLA
IN:
Som
etim
es w
e ha
ve s
ever
al p
robl
ems
that
pre
vent
us
from
hav
ing
drug
s av
aila
ble.
If
we
can
iden
tify
thes
e, w
e ca
n se
e w
hich
one
s w
e m
ay d
o so
met
hing
abo
ut. W
e ar
e ca
lling
thes
e pr
oble
ms
‘red
light
’ iss
ues.
Whe
n th
ere
are
no p
robl
ems,
we
say
ever
ythi
ng is
on
track
, or ‘
gree
n lig
ht’.
Not
e to
Tra
iner
: R
ecei
ve re
spon
ses
and
try a
nd li
nk b
ack
to th
e pr
oble
ms/
chal
leng
es
iden
tifie
d ea
rlier
. Re
fer p
artic
ipan
ts to
pag
e 27
.
Step
2:
ACT
IVIT
Y G
– D
rug
Dis
trib
utio
n Sy
stem
Cas
e St
udy
Act
ivity
Ste
ps
1) A
sk fo
r a p
artic
ipan
t to
read
the
case
stu
dy o
n pa
ge 2
6 ou
t lou
d.
CA
SE S
TUD
Y: J
osep
h is
an
in-c
harg
e of
a h
ealth
cen
tre II
. Th
e bi
-mon
thly
di
strib
utio
n of
dru
gs fr
om N
MS
to th
e D
istri
ct o
ccur
red
last
Frid
ay, b
ut Jo
seph
ha
s no
t hea
rd fr
om th
e H
ealth
Sub
-Dis
trict
abo
ut w
hen
to p
ick
up d
rugs
for
his
heal
th c
entre
. H
e al
so re
aliz
ed th
at h
e ha
s no
mea
ns to
go
and
pick
up
the
drug
s. F
inal
ly, th
e dr
ugs
wer
e br
ough
t to
the
heal
th c
entre
, but
whe
n th
ey a
rriv
ed, J
osep
h sa
w th
at th
e lo
ck o
n th
e st
orag
e cu
pboa
rd w
as b
roke
n so
ther
e w
as n
o se
cure
pla
ce to
sto
re th
e dr
ugs.
Jos
eph
ente
red
the
drug
s he
rece
ived
on
the
Stoc
k Ca
rd.
One
mon
th la
ter,
Jose
ph re
view
ed h
is S
tock
Ca
rds
and
real
ized
that
he
was
nea
ring
the
min
imum
mon
thly
con
sum
ptio
n fo
r Coa
rtem
. Jo
seph
dec
ided
to s
ubm
it a
requ
est f
or re
-sup
ply,
but
saw
that
he
did
not
hav
e a
copy
of t
he ‘O
rder
For
m’.
Als
o, n
one
of th
e ot
her h
ealth
ce
ntre
sta
ff ar
e aw
are
of th
e cu
rren
t am
ount
of C
oarte
m a
vaila
ble
at th
e he
alth
cen
tre.
Step
3: A
SK:
How
doe
s th
is c
ase
stud
y co
mpa
re w
ith y
our o
wn
expe
rienc
es?
Hav
e yo
u ha
d ex
perie
nces
like
this
bef
ore?
Step
5: A
SK:
Can
som
eone
tell
me
wha
t Jos
eph
did
wel
l, w
hat w
as a
‘gre
en li
ght’?
Wha
t Jos
eph
did
well
����
����
����
����
����
he
rece
ived
on
the
Stoc
k Ca
rd
���
����
���
����
�
Stoc
k Ca
rd
Drug
Sup
ply
activ
ity c
ard
�����
����
��
��
���
���
���
��
�
leve
ls f
or A
L/
drug
s
Not
e to
Tra
iner
:A
s pa
rtici
pant
s pr
ovid
e th
e ‘g
reen
ligh
t’ ite
ms,
pla
ce th
e co
rres
pond
ing
‘Dru
g Su
pply
act
ivity
’ car
d ne
xt to
the
step
in th
e dr
ug d
istri
butio
n sy
stem
dia
gram
fro
m th
e be
ginn
ing
of th
e m
odul
e (s
ee b
elow
).
Th
e is
sue
and
corr
espo
ndin
g D
rug
Supp
ly a
ctiv
ity a
re a
s fo
llow
s.
3637
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Step
6: E
XPLA
IN:
Now
, at y
our t
able
s, I’
d lik
e yo
u to
go
back
thro
ugh
the
case
stu
dy a
nd u
nder
line
wha
t you
con
side
r to
be ‘r
ed li
ght’
issu
es.
Then
I’d
like
you
to d
ecid
e w
hat t
ype
of
activ
ity in
the
drug
dis
tribu
tion
syst
em th
e ‘re
d lig
ht’ i
ssue
is.
Jose
ph’s
‘red
light
’ iss
ues i
n th
e cas
e st
udy
���
���
���
� ��
���
��
the
Dis
tric
t or
Hea
lth
Sub
-Dis
tric
t ab
out
when
to
pick
up
drug
s
���
��
� �
���
���
���
pick
up
the
drug
s
����
���
�!�
���
���
���
the
drug
s
����
���
���
���
�
!"�
��
the
‘Ord
er F
orm
’
���
���
���
���
��
����
cen
tre
staf
f ar
e
awar
e of
the
curr
ent
amou
nt
of C
oart
em
Drug
Sup
ply
activ
ity
card
�����
���
���
����
���!
���
�!�
from
the
HSD
or H
C IV
/III
����
��!
��
���
���
����
��
����
� �
���
����
���
����
��
hea
lth
cen
tre
��#
����
���
����
��!!
�"�
��$
%�
(Coa
rtem
)
����
���
� �
���
���
��
staf
f re
gard
ing
AL/
drug
stoc
ks
Not
e to
Tra
iner
:Pr
ovid
e on
e se
t of t
he ‘D
rug
Supp
ly A
ctiv
ity C
ards
’ (A
nnex
I) to
eac
h ta
ble.
A
llow
5 m
inut
es.
Th
en a
sk th
e gr
oups
to fe
edba
ck th
eir a
nsw
ers
incl
udin
g:
- 1)
the
‘red
light
’ iss
ues
they
und
erlin
ed, a
nd
- 2)
the
corr
espo
ndin
g D
rug
Supp
ly a
ctiv
ity c
ard.
Not
e to
Tra
iner
: W
hen
all o
f the
Dru
g Su
pply
Act
ivity
Car
ds a
re p
lace
d, th
e dr
ug d
istri
butio
n di
agra
m s
houl
d lo
ok li
ke th
is b
elow
:
Dis
trict
Hea
lth O
ffice
(DH
O) r
ecei
ves
drug
s fro
m th
e N
atio
nal M
edic
al S
tore
s (N
MS)
Hea
lth S
ub-D
istri
ct (H
SD) r
ecei
ves
drug
s fro
m th
e D
HO
Hea
lth C
entre
IV re
ceiv
e dr
ugs
fro
m th
e H
SD
Hea
lth c
entre
II/I
IIs re
ceiv
e dr
ugs
from
he
alth
cen
tre IV
s
Dat
e of
dru
g pi
ck-u
p fro
m th
e H
SD o
r H
C IV
/III
Tran
spor
tatio
n of
dru
gs to
hea
lth c
entre
Stor
age
at h
ealth
cen
tre
Dru
g St
ock
Card
sta
tus
Mon
itor S
tock
leve
ls fo
r AL
/ RD
Ts
NM
S Su
pply
or O
rder
for r
e-su
pply
of
AL/
RDTs
, if r
equi
red
Com
mun
icat
ion
with
sta
ff re
gard
ing
AL/
RDT
stoc
ks
Oth
er a
ctiv
ities
this
per
iod
Dru
gs a
re re
ceiv
ed a
t the
hea
lth c
entre
an
d en
tere
d on
a S
tock
Car
d
Dru
gs a
re p
resc
ribed
, giv
en to
pat
ient
s,
and
reco
rded
on
the
out-p
atie
nt
depa
rtmen
t reg
iste
r and
the
Stoc
k Ca
rd
The
HSD
/ h
ealth
cen
ter I
V is
not
ified
w
hen
ther
e ar
e st
ock-
outs
3839Trainer Manual - HCM 02
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
esTo
pic
2: K
eepi
ng tr
ack
of d
rug
dist
ribut
ion
activ
ities
Not
e to
Tra
iner
: G
o to
the
AD
DAT
(Tra
iner
Ann
ex J)
and
refe
r par
ticip
ants
to p
age
61 in
th
e Le
arne
r Man
ual a
nd g
ive
parti
cipa
nts
1-2
min
utes
to re
ad it
ove
r.
Rem
embe
r, th
e A
DD
AT is
a n
ew to
ol, s
o th
e pa
rtici
pant
s w
ill n
eed
som
e tim
e to
get
fam
iliar
with
it.
Not
e to
Tra
iner
: F
or th
e ne
xt a
ctiv
ities
, div
ide
the
grou
p in
to tw
o an
d us
e yo
ur c
o-tra
iner
to
lead
eac
h ha
lf th
e gr
oup
thro
ugh
the
activ
ity.
A
sk p
artic
ipan
ts to
turn
to th
eir A
DD
AT in
the
Lear
ner M
anua
l, pa
ge 6
1 and
co
mpl
ete
the
AD
DAT
toge
ther
with
you
as
you
all w
ork
thro
ugh
the
activ
ity.
Fo
r eac
h ac
tivity
on
the
AD
DAT
wor
k th
roug
h th
e fo
llow
ing
step
s. M
ake
sure
th
at e
very
one
in th
e gr
oup
has
unde
rsto
od.
Ther
e m
ight
be
som
e co
nfus
ion,
so
go
slow
and
be
sure
eve
ryon
e ha
s an
opp
ortu
nity
to a
sk a
ny q
uest
ions
. Re
fer t
o th
e sa
mpl
e A
DD
AT Tr
aine
r Ann
ex J.
Step
3: E
XPLA
IN:
Fo
r Jos
eph’
s ca
se s
tudy
, we
have
cre
ated
one
type
of c
heck
list.
It li
sts
all o
f the
ac
tiviti
es w
e id
entif
ied
in th
e ca
se s
tudy
. It
uses
a ‘g
reen
’, ‘ye
llow
’, ‘re
d’ s
yste
m to
he
lp u
s un
ders
tand
if th
e ac
tivity
is:
- G
reen
= o
n tra
ck
- Ye
llow
= m
ovin
g sl
owly,
som
e w
ork
is re
quire
d to
get
the
activ
ity o
n tra
ck
- Re
d =
not o
n tra
ck, m
uch
wor
k is
requ
ired
to g
et th
e ac
tivity
on
track
W
e ar
e ca
lling
this
che
cklis
t the
ACT
Dru
g D
istri
butio
n As
sess
men
t Too
l (AD
DAT
)
Not
e to
Tra
iner
: R
ecei
ve re
spon
ses
from
par
ticip
ants
. Re
fer p
artic
ipan
ts to
pag
e 29
.
Step
2: A
SK:
H
ow d
o yo
u fe
el a
bout
usi
ng a
che
cklis
t to
keep
trac
k of
the
activ
ities
you
co
mpl
ete
to k
eep
the
drug
dis
tribu
tion
syst
em w
orki
ng?
Step
2:
Step
1: E
XPLA
IN:
In
our
cas
e st
udy,
ther
e w
ere
eigh
t act
iviti
es re
quire
d to
get
dru
gs to
the
heal
th
cent
re.
O
ne w
ay to
thin
k ab
out a
ll of
thes
e ac
tiviti
es is
to c
reat
e a
chec
klis
t. A
che
cklis
t he
lps
us to
kee
p tra
ck o
f all
the
wor
k w
e ha
ve d
one,
or n
eed
to d
o, to
com
plet
e a
task
.
3. P
rinci
ples
10
min
utes
Trai
ning
Ste
ps
Step
1: E
XPLA
IN:
Le
t’s s
ee h
ow w
e co
uld
use
this
che
cklis
t, th
e AD
DAT
, to
help
Jose
ph k
eep
track
of
his
activ
ities
.
4. P
ract
ice
15
min
utes
Trai
ning
Ste
ps
ACT
IVIT
Y H
– D
rug
Dis
trib
utio
n Sy
stem
Cas
e St
udy
Act
ivity
Ste
ps
1) A
SK fo
r a p
artic
ipan
t to
iden
tify
the
issu
e fro
m th
e ca
se s
tudy
.
2) T
hen
desc
ribe
how
you
wou
ld re
cord
it o
n th
e A
DD
AT b
y w
ritin
g th
e de
scrip
tion
on th
e fli
p ch
art.
Ask
par
ticip
ants
to d
o th
e sa
me
on th
eir A
DD
AT.
3) A
SK p
artic
ipan
ts h
ow th
ey w
ould
reso
lve
the
issu
e.
4) T
here
may
be
seve
ral d
iffer
ent w
ays
to re
solv
e th
e is
sue.
5) P
ICK
one
of th
e an
swer
s an
d de
scrib
e ho
w y
ou w
ould
reco
rd it
on
the
AD
DAT
by
writ
ing
the
desc
riptio
n on
the
flip
char
t.
6) A
SK p
artic
ipan
ts to
do
the
sam
e on
thei
r AD
DAT
.
4041
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Dru
g Su
pply
Act
ivity
Stat
us &
Des
crip
tion
Reso
lutio
nTh
e da
te o
f dru
g pi
ck-u
p fro
m th
e H
SDYe
llow
: kno
w d
rugs
hav
e ar
rived
, but
hav
en’t
been
to
ld to
pic
k th
em u
p
Call
the
Hea
lth S
ub-D
istri
ct
to a
rran
ge a
dat
e to
pic
k up
th
e dr
ugs
Tran
spor
tatio
n fo
r dru
gs
from
HSD
to h
ealth
cen
treRe
d: th
ere
is n
o w
ay to
pic
k up
the
drug
sU
se m
oney
from
the
PHC
fund
to s
end
a bo
da to
pic
k th
e dr
ugs
Stor
age
of d
rugs
at t
he
heal
th c
entre
?Ye
llow
: the
re is
no
lock
for
the
stor
age
cupb
oard
Use
mon
ey fr
om th
e PH
C fu
nd to
buy
a lo
ckTh
e St
ock
Card
Gre
en: t
he d
rug
stoc
k-ca
rd
has
been
com
plet
e fo
r all
dose
s of
Coa
rtem
No
need
for a
ctio
n.
Cont
inue
to u
se a
nd
mon
itor t
he d
rug
Stoc
k Ca
rdSt
ocks
for A
L /
RDTs
Yello
w: s
tock
s ar
e ne
arin
g th
e m
inim
um c
onsu
mpt
ion
and
an o
rder
is re
quire
d
Det
erm
ine
the
amou
nt to
be
ord
ered
bas
ed o
n th
e St
ock
Card
NM
S Su
pply
or O
rder
for
re-s
uppl
y of
AL/
RDTs
, if
requ
ired
Red:
no
orde
r for
m
avai
labl
e to
ord
er fr
om th
e D
istri
ct
Ask
for a
cop
y of
the
Ord
er
Form
from
the
HSD
Com
mun
icat
ion
with
sta
ff re
gard
ing
AL/
RDT
stoc
ksRe
d: th
e st
aff d
o no
t kno
w
how
muc
h Co
arte
m is
left
Hav
e a
10 m
inut
e m
eetin
g w
ith h
ealth
wor
kers
to
revi
ew th
e am
ount
of
Coar
tem
ava
ilabl
e an
d w
hen
the
next
sto
ck is
ex
pect
ed
7) A
SK th
e pa
rtici
pant
s to
rem
ain
in th
eir t
wo
grou
ps.
Step
3: E
XPLA
IN:
Jose
ph’s
case
stu
dy w
as a
goo
d ex
ampl
e to
get
us
thin
king
abo
ut th
e ‘re
d’, ‘
gree
n’
and
‘yello
w’ i
ssue
s. T
here
are
man
y m
ore.
We
have
cre
ated
a c
hart
of s
ome
othe
r ex
ampl
es; t
his
in o
n pa
ge 6
3 of
you
r Lea
rner
Man
ual (
Trai
ner A
nnex
K).
Rem
embe
r, th
e AD
DAT
is ju
st o
ne ty
pe o
f che
cklis
t. Y
ou m
ay fi
nd a
noth
er fo
rmat
or
list t
hat w
orks
bet
ter f
or y
ou a
t you
r hea
lth c
entre
.
Hom
e ac
tivity
On
page
30
you
will
find
an a
ctiv
ity to
do
at h
ome.
We
enco
urag
e yo
u to
look
at
this
cha
rt af
ter t
he tr
aini
ng to
see
if it
com
pare
s to
you
r exp
erie
nces
at y
our h
ealth
ce
ntre
.
- D
o yo
u fa
ce th
ese
sam
e is
sues
at y
our h
ealth
cen
tre?
- D
o yo
u ag
ree
with
the
reso
lutio
n lis
ted?
- W
hat w
ould
you
do
diffe
rent
ly?
- W
hat o
ther
act
iviti
es w
ould
you
like
to k
eep
track
of?
Step
2: E
XPLA
IN:
Id
entif
ying
and
kee
ping
trac
k of
the
issu
es is
a v
ery
impo
rtant
firs
t ste
p in
im
prov
ing
the
drug
dis
tribu
tion
syst
em.
It
may
als
o be
pos
sibl
e to
find
mor
e pe
rman
ent s
olut
ions
to p
robl
ems
that
oc
cur f
requ
ently
. It
may
eve
n be
pos
sibl
e to
use
you
r tra
ckin
g re
ports
to
dem
onst
rate
you
r cha
lleng
es to
the
Hea
lth S
ub-D
istri
ct o
r Dis
trict
, whi
ch c
an
help
them
to k
now
the
best
way
s to
hel
p yo
u.
5. D
iscu
ssio
n
10
min
utes
Trai
ning
Ste
ps
Step
1: A
SK:
Wha
t can
you
see
mig
ht b
e th
e be
nefit
s to
you
as
in-c
harg
es if
you
are
abl
e to
kee
p tra
ck o
f act
iviti
es y
ou d
o at
you
r hea
lth c
entre
s?
6. P
lann
ing
10
min
utes
Trai
ning
Ste
ps
Step
1: A
SK:
H
ow c
ould
you
kee
p tra
ck o
f the
dru
g di
strib
utio
n sy
stem
act
iviti
es a
t you
r hea
lth
cent
re?
Pl
ease
wor
k w
ith o
ther
s at
you
r tab
le u
sing
the
Activ
ity S
heet
on
page
31 a
nd 3
2 in
you
r Lea
rner
Man
ual t
o de
velo
p yo
ur o
wn
drug
dis
tribu
tion
syst
em c
heck
list f
or
your
hea
lth c
entre
. Yo
u co
uld
use
the
chec
klis
t fro
m to
day’s
act
iviti
es o
r you
cou
ld
chan
ge it
to b
ette
r sui
t you
r nee
ds a
nd e
xper
ienc
es.
- W
hat d
rug
dist
ribut
ion
activ
ities
wou
ld y
ou li
ke to
kee
p tra
ck o
f?
- W
hen
wou
ld y
ou u
se y
our c
heck
list?
- H
ow c
ould
you
use
this
che
cklis
t to
mak
e im
prov
emen
ts to
the
way
you
id
entif
y an
d re
solv
e is
sues
?
- W
hat w
ould
you
like
you
r che
cklis
t to
look
like
?
Not
e to
Tra
iner
: E
ncou
rage
par
ticip
ants
to p
rovi
de a
s m
any
answ
ers
as p
ossi
ble.
Pro
be
gene
ral r
espo
nses
(for
exa
mpl
e if
parti
cipa
nts
say,
‘it i
s go
od’)
to a
sk h
ow it
m
ight
cha
nge
wha
t the
y cu
rren
tly d
o an
d ex
perie
nce.
4243Trainer Manual - HCM 02
Trainer Manual - HCM 02
Topi
c 2:
Kee
ping
trac
k of
dru
g di
strib
utio
n ac
tiviti
es
Not
e to
Tra
iner
: G
ive
parti
cipa
nts
10 m
inut
es to
wor
k w
ith o
ther
s at
thei
r tab
le to
com
plet
e th
e A
ctiv
ity S
heet
.
M
ove
betw
een
grou
ps a
nd o
ffer s
ugge
stio
ns if
pra
ctic
al.
For e
xam
ple:
W
hen
wou
ld y
ou u
se y
our c
heck
list?
- Ke
ep c
ompl
eted
che
cklis
ts in
a fo
lder
or b
ox fi
le fo
r eas
y ac
cess
eac
h m
onth
- Pi
ck a
day
of t
he w
eek
/ m
onth
to re
view
the
chec
klis
t
H
ow c
ould
you
use
this
che
cklis
t to
mak
e im
prov
emen
ts to
the
way
yo
u id
entif
y an
d re
solv
e is
sues
?
- A
lway
s re
view
last
mon
ths’
che
cklis
t w
hen
com
plet
ing
the
curr
ent
chec
klis
t
- Ke
ep tr
ack
of th
e is
sues
and
see
if th
e sa
me
issu
es k
eep
occu
rrin
g
- M
ake
a lis
t of t
he m
ost c
omm
on a
ctiv
ities
that
cau
se p
robl
ems
and
disc
uss
with
oth
er in
-cha
rges
or a
repr
esen
tativ
e fro
m th
e H
ealth
Sub
-D
istri
ct
Conc
lusi
on
D
rug
dist
ribut
ion
is ju
st li
ke th
is g
ame
– w
hen
thin
gs a
re w
orki
ng (g
reen
ligh
t),
the
syst
em a
t you
r hea
lth c
entre
mov
es fo
rwar
d an
d pa
tient
s re
ceiv
e th
e rig
ht
treat
men
t.
W
hen
you
expe
rienc
e a
bloc
k in
the
syst
em (r
ed li
ght),
eve
ryth
ing
at y
our h
ealth
ce
ntre
sto
ps a
nd d
rugs
are
not
ava
ilabl
e to
car
e fo
r you
r pat
ient
s.
A
che
cklis
t hel
ps u
s to
kee
p tra
ck o
f all
the
wor
k w
e ha
ve d
one,
or n
eed
to d
o,
to c
ompl
ete
a ta
sk.
A
che
cklis
t lis
ts a
ll of
the
activ
ities
we
iden
tifie
d in
the
case
stu
dy.
It us
es a
‘g
reen
’, ‘y
ello
w’,
‘red’
sys
tem
to h
elp
us u
nder
stan
d if
the
activ
ity is
:
- G
reen
= o
n tra
ck
- Ye
llow
= m
ovin
g sl
owly,
som
e w
ork
is re
quire
d to
get
the
activ
ity o
n tra
ck
- Re
d =
not o
n tra
ck, m
uch
wor
k is
requ
ired
to g
et th
e ac
tivity
on
track
Th
e A
CT D
rug
Dis
tribu
tion
Ass
essm
ent T
ool (
AD
DAT
) che
cklis
t is
one
kind
of
chec
klis
t. In
-cha
rges
can
dev
elop
new
che
cklis
ts a
s ne
eded
to m
eet s
peci
fic
heal
th c
entre
nee
ds.
Sum
mar
y Bo
x –
Dru
g D
istr
ibut
ion
Syst
em &
For
ms
For r
efer
ence
for t
rain
ers
and
lear
ners
CON
CLU
SIO
N
Tota
l Tim
e: 5
min
utes
Purp
ose:
To c
lose
the
HCM
02
train
ing
and
rece
ive
any
ques
tions
or a
ddre
ss a
ny
ques
tions
in th
e pa
rkin
g lo
t.
Mat
eria
ls re
quire
d:
Flip
cha
rt M
arke
rs
Tape
Trai
ning
met
hods
use
d:
Trai
ner e
xpla
natio
n
Page
35
5 m
inut
es
Trai
ning
Ste
ps
Step
1: E
XPLA
IN:
This
is n
ow th
e en
d of
the
sess
ion
and
an o
ppor
tuni
ty fo
r you
to a
sk a
ny q
uest
ions
an
d fo
r me
to a
nsw
er a
ny q
uest
ions
in th
e pa
rkin
g lo
t.
Step
2: A
SK:
Let’s
look
bac
k at
our
lear
ning
out
com
es in
our
Lear
ner M
anua
l on
page
9.
Doe
s an
yone
hav
e an
y co
mm
ents
or q
uest
ions
abo
ut w
hat w
e ha
ve c
over
ed to
day?
Doe
s an
yone
hav
e an
y co
mm
ents
or q
uest
ions
abo
ut w
hat w
e ha
ve c
over
ed
toda
y? P
leas
e co
mm
ent o
n w
hat y
ou th
ink
help
ed y
ou le
arn
wel
l, an
d w
hich
poi
nts
may
stil
l be
uncl
ear.
Not
e to
Tra
iner
: M
ake
a no
te o
f any
sug
gest
ions
or q
uerie
s in
you
r man
ual a
nd fo
llow
up
on
thes
e fo
r the
nex
t mod
ule
whe
re p
ossi
ble.
A
ddre
ss a
ny n
ew q
uest
ions
.
A
nsw
er a
ny q
uest
ions
stil
l wai
ting
in th
e pa
rkin
g lo
t.
4445
Trainer Manual - HCM 02
Conc
lusi
on
Step
3: E
XPLA
IN:
Th
ank
you
for p
artic
ipat
ing
toda
y!
Sh
arin
g yo
ur e
xper
ienc
e an
d in
sigh
t has
bee
n ve
ry h
elpf
ul a
nd in
form
ativ
e.
Plea
se u
se th
e Le
arne
r’s M
anua
l reg
ular
ly to
revi
ew w
hat y
ou h
ave
lear
ned.
D
iscu
ss a
ny c
halle
nges
with
you
r col
leag
ues;
they
will
be m
ost h
elpf
ul fo
r fin
ding
so
lutio
ns to
pro
blem
s an
d ch
alle
nges
at y
our h
ealth
cen
tre. G
oodb
ye.
Trainer Manual - HCM 02
Ann
exA
nnex
A
- Pre
-pre
pare
d D
rug
D
istri
butio
n St
eps
47
Ann
ex B
- B
lank
Sto
ck C
ard
49
Ann
ex C
- C
ompl
eted
sto
ck c
ard
for 1
2 ta
b 5
1
Ann
ex D
- H
MIS
OPD
Reg
iste
r 53
Ann
ex E
- C
ompl
eted
sto
ck c
ard
for 1
2 ta
b 5
7
Ann
ex F
-1 -
Com
plet
ed s
tock
car
d fo
r 6 ta
b 59
Ann
ex F
-2 -
Com
plet
ed s
tock
car
d fo
r 12
tab
61
Ann
ex F
-3 -
Com
plet
ed s
tock
car
d fo
r 18
tab
63
Ann
ex F
-4 -
Com
plet
ed s
tock
car
d fo
r 24
tab
65
Ann
ex G
- C
ompl
eted
Ord
er F
orm
67
Ann
ex H
- B
lank
Ord
er F
orm
69
Ann
ex I
- D
rug
Supp
ly A
ctiv
ity C
ards
71
Ann
ex J
- A
DD
AT D
rug
Dis
tribu
tion
A
sses
smen
t Too
l 75
Ann
ex K
- A
DD
AT C
hart
77
Your
Not
es
A go
od p
lace
to w
rite
the
nam
es o
f par
ticip
ants
or q
uest
ions
that
aris
e.
4647
Ann
ex A
- P
re-p
repa
red
Dru
g D
istr
ibut
ion
Step
s
Hea
lth S
ub-D
istri
ct (H
SD) r
ecei
ves
drug
s
from
the
DH
O
Dis
trict
Hea
lth O
ffice
(DH
O) r
ecei
ves
drug
s fro
m th
e N
atio
nal M
edic
al S
tore
s (N
MS)
Hea
lth c
entre
II/I
IIs re
ceiv
e dr
ugs
fro
m h
ealth
cen
tre IV
s
Dru
gs a
re re
ceiv
ed a
t the
hea
lth c
entre
an
d en
tere
d on
a S
tock
Car
d
Dru
gs a
re p
resc
ribed
, giv
en to
pat
ient
s,
and
reco
rded
on
the
out-
patie
nt
depa
rtmen
t reg
iste
r
Hea
lth C
entre
IVs
rece
ive
drug
s fro
m th
e H
SD
Hea
lth C
entre
IVs
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ive
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s fro
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e H
SD
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4849
Ann
ex B
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tock
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d -
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k
ST
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D
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it N
am
e:
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ex D
- C
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r
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(5)
(6)
(7)
(8)
(9)
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R
NU
MN
AM
E O
F PA
TIE
NT
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CE
NE
XT
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FN
EW
C
AS
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E-
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bot
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elK
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wor
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tim J
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aria
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tcho
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fwon
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XC
onju
nctiv
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don
go S
teve
nM
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Ann
ex D
- C
ompl
eted
OPD
Reg
iste
r
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
SE
R
NU
MN
AM
E O
F PA
TIE
NT
RE
SID
EN
CE
NE
XT
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KIN
AG
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WE
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ME
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bot
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eter
2X
10X
Mal
aria
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arte
m, 1
bd
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g td
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02/2
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lex
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rem
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ang
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ly x
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s x
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04/2
011
Y36
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N
15N
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g td
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125
mg
tds
x 3/
7,C
ough
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2.5m
ls t
ds
x 5/
7
Y39
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P
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wor
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YN
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38.4
YP
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tds
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7Y
38.9
YP
19E
kira
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Pas
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AN
awire
Oku
ga M
artin
2X
11X
Mal
aria
Lum
arte
m, 1
bd
x 3
/7P
anad
ol 2
50m
g td
s x
3/7
Y36
.4Y
P
20N
yake
tcho
Lu
cyS
engo
Bar
inya
ngO
fwon
o G
eral
d4
X20
XC
onju
nctiv
itis
Gen
tam
ycin
eye
2 d
rop
s x
5/7
Tetr
acyc
line
eye
oint
men
t ap
ply
noct
e
N36
.9N
N/A
21O
don
go S
teve
nM
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i Roc
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opS
opE
lub
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hile
mon
8X
27X
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aria
Lum
arte
m, 3
bd
x 3
/7P
anad
ol 2
50 m
g td
s x
3/7
Y38
.8Y
P
22A
sind
e P
eace
Nab
oa
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thN
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ring
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ce2
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XM
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d x
3 /
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ol 2
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s x
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13/2
011
05/2
011
Y38
.2Y
P
5657
Ann
ex E
- C
ompl
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sto
ck c
ard
for 1
2 ta
b
ST
OC
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AR
D
He
alth
Un
it N
am
e:
__
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crip
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7475
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I know the drugs have arrived, but I haven’t been told
when to pick them
Called the HSD/HCIV (Mr Kizito) and arranged a date
to pick the drugs (tomorrow) 05/03/11
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I have no transport to go and pick the drugs Used money from the PHC Fund to use a boda to pick
the drugs 06/03/11
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There is no lock on the storage cupboard so the drugs
are not secure
Used the PHC Fund to buy a lock for the storage
cupboard 05/03/11
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The Stock Card is complete for all does of Coartem and
RDTs
Will continue using the Stock Card
05/03/11
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Stocks of Coartem are nearing the minimum monthly
consumption. An order is needed.
Used the Stock Card to determine how much Coartem to
order 28/03/11
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The staff do not know how much Coartem is in stock Planning a 10 minute meeting to update staff
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7677
Ann
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ActivityGreenYellowHow to resolveRedHow to resolveThe date of drug pick-up from the HSD
− I know the date to pick drugs from HCI
− Drugs have arrived but I have not been told to pick them
− I have not received the date of the next NMS supply so I can’t plan to pick drugs
− Call/visit the HCIV to arrange a date for pick-up
− Call/visit/ask the HCIV for the next scheduled NMS supply date to help you plan your orders
− No one is available to tell me when to pick drugs
− Call/visit the HCIV to find someone to speak with, or leave a message
− Follow-up regularly and document you attempts to make contact
Transportation for drugs from HSD to health centre
− The HCIV is delivering the drugs
− I am using PHC Fund to take a boda to pick drugs
− I have not budgeted the PHC Fund to pick the drugs
− I have a boda but no fuel to pick the drugs
− The rains are too much and I can’t pick the drug using a boda like I usually do
− Use the ‘contingency’ from your PHC Fund budget to pay for the boda, get a receipt
− Explain the situation to the HCIV to see if they can help by sending the drugs in a truck
− The road is washed-out and there is no transportation to/from HCIV
− My boda/bike is broken and there are no funds for repairs, so I can’t pick the drugs
− Ask the HCIV to safely store your drugs until you can collect/transport them
− Explain the situation to the HCIV to see if they can help by sending the drugs in a truck
Storage of drugs at the health centre
− The storage cupboard is clean and secure
− The storage cupboard has no lock
− The storage space is always flooded so drugs spoil
− The storage cupboard is full
− Use the PHC Fund to purchase a lock
− Use the PHC Fund to get shelves made for the storage space to keep the drugs off the ground (or use benches, crates, etc)
− Clean the storage cupboard to removed expired drugs and drug/supplies that are never used
− There is no secure storage place at the health centre
− I can not leave the drugs at the health centre because there are thieves at night
− The storage place was burgled
− Use the PHC Fund to purchase a lock box or small cupboard for storage
− See if there are steps you can take to make the health centre more safe. Ask a staff member to witness you transporting the drugs.
− Make a report to the HCIV about the burglary. See how you can prevent the burglary in the future
7879
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ActivityGreenYellowHow to resolveRedHow to resolveThe Stock Card− The Stock Card is
complete for all doses of Coartem and all RDTs
− The Stock Card is up to date as of this week
− Only some of the Stock Cards are complete
− The Stock Card(s) has not been updated
− I lost my mobile so I can’t do the Stock Card calculations
− Plan for a day in the week to complete/update the Stock Cards
− Ask to borrow a mobile, purchase a calculator for the health centre with the PHC Fund
− The Stock Card(s) is lost/missing
− I do not have copies of the Stock Card
− Start a new Stock Card using the OPD or a previous Stock Card to calculate the AMC, min/max stock levels.
− Use the PHC Fund to make copies, or draw a version of the Stock Card in a notebook
Stocks for AL/RDT− All Coartem is in stock− There is enough
Coartem/RDT to last until the next NMS distribution
− Coartem/RDTs are nearing/have reached the minimum monthly consumption
− I do not know how many drugs are in stock, but I think there will be a stock-out soon
− Use Stock Card to determine how much Coartem/RDT to order
− Use your last Order Form from to estimate how many drugs you will need for this order
− There is a stock out − The health centre was
burgled /flooded/damage and stocks were lost
− Place an order for Coartem/AL immediately. Determine why there was a stock-out (order not placed in time, previous order insufficient) to prevent the stock-out in the future
− Report the damage to the HCIV. Make an order to replace the stocks of Coartem/RDTs.
8081
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ActivityGreenYellowHow to resolveRedHow to resolveNMS Supply or Order for re-supply of AL/RDTs, if required
− Order for re-supply of AL/RDTs placed
− NMS supply / or Order received this month
− NMS supply is delayed− I placed my order for
re-supply of Coartem late and there may be a stock-out
− I placed my order but the HCIV said it was not received
− Ask the HCIV when the NMS supply is expected. Determine if you have enough Coartem/RDTs to last, and place an order if required
− Confirm with the HCIV that the Order Form was not received, then make a new copy of the Order Form from your files and send
− NMS supply did not arrive
− I have not ordered for re-supply of Coartem/RDTs
− I placed my order by phone so it was not recorded/filled
− Ask the HCIV if the NMS supply is expected soon. Determine if you have enough Coartem/RDTs to last, and place an order if required
− Determine why you did not place the order (no Stock Card, no Order Form, I was away) to ensure you prevent this next time. Place an order for re-supply of Coartem/RDTs
Communication with staff regarding drug/AL/RDT stocks
− There is regular communication between staff about stocks
− I am the only staff person!
− I am not here when the other staff are so I can not communicate with them
− Write a message in a note book, or place it on the wall, so that the staff can read it when they are at the health centre
− I planned a meeting, but staff did not attend
− Ask staff why they were not able to attend, plan together for another meeting
8283
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ActivityGreenYellowHow to resolveRedHow to resolveOther activities this period
− I met with the HCIV about the drug supply. I wrote notes and filed with the ADDAT.
− I attended training on supply management. I told my co-workers what I learned.
− The volunteer cleaned the storage cupboard. We removed expired medications and moved soon-to-expire medications to the front of the shelves.
− A politician came to visit. I showed him our stocks and Stock Cards. He was impressed.
− − − −
84
The ACT PRIME Study Infectious Diseases Research Institute, Uganda The ACT Consortium, United Kingdom
Date of publication: 2011 Technical Support on Manual Development provided by:
WellSense International Public Health Consultants
www.wellsense-iphc.com
Manual designed by: Spot On Design
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International Public Health Consultants
The ACT PRIME Study
Infectious Disease Research Collaboration, Uganda.ACT Consortium, London School of Hygiene & Tropical Medicine, UK.